Real-world outcomes of maintenance therapy post-autologous stem cell transplantation in newly diagnosed multiple myeloma
Abstract Background In the Republic of Korea, only lenalidomide, bortezomib, ixazomib, and thalidomide monotherapy are available as maintenance therapy post-autologous stem cell transplantation (ASCT). Methods To determine whether maintenance therapy confers a survival benefit in the real world, we...
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2025-02-01
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| Online Access: | https://doi.org/10.1186/s12885-025-13518-0 |
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| author | Ka-Won Kang Dae Sik Kim Se Ryeon Lee Mi Hwa Heo Hyeon-Seok Eom Jongheon Jung Ji Hyun Lee Sung-Hyun Kim Youngil Koh Chang-Ki Min Seung Shin Lee Sung-Nam Lim Ho-Young Yhim Myung-won Lee Je-Jung Lee Sung-Hoon Jung Soo-Mee Bang Kihyun Kim the Korean Multiple Myeloma Working party [KMMWP] |
| author_facet | Ka-Won Kang Dae Sik Kim Se Ryeon Lee Mi Hwa Heo Hyeon-Seok Eom Jongheon Jung Ji Hyun Lee Sung-Hyun Kim Youngil Koh Chang-Ki Min Seung Shin Lee Sung-Nam Lim Ho-Young Yhim Myung-won Lee Je-Jung Lee Sung-Hoon Jung Soo-Mee Bang Kihyun Kim the Korean Multiple Myeloma Working party [KMMWP] |
| author_sort | Ka-Won Kang |
| collection | DOAJ |
| description | Abstract Background In the Republic of Korea, only lenalidomide, bortezomib, ixazomib, and thalidomide monotherapy are available as maintenance therapy post-autologous stem cell transplantation (ASCT). Methods To determine whether maintenance therapy confers a survival benefit in the real world, we compared treatment outcomes according to the use and type of maintenance therapy in patients who underwent ASCT following frontline therapy with the triplet regimen of bortezomib, thalidomide, and dexamethasone for newly diagnosed multiple myeloma in 15 nationwide centers. Results A total of 512 patients were analyzed (no-maintenance group, n = 359, and maintenance group, n = 153 patients). Among those receiving maintenance therapy, 104 (68%) received thalidomide, 33 (21%) lenalidomide, and 16 (10%) bortezomib or ixazomib. The median progression-free survival (PFS) from the time of ASCT was 26.4 and 44.1 months in the no-maintenance and maintenance groups, respectively. In the multivariate analysis, the use of maintenance therapy was significantly associated with better PFS. After adjustment for the type and duration of maintenance therapy, the use of bortezomib or ixazomib was associated with better PFS than other drugs. Longer duration of therapy was associated with improved PFS. No statistically significant difference was observed in overall survival and secondary malignancy rates by use or type of maintenance. Conclusion Despite practical limitations, maintenance therapy after ASCT demonstrated a gain in PFS in the real world, and there was no clear increase in the risk of secondary malignancy. Therefore, it may be prudent to consider implementing maintenance therapy in a feasible manner. |
| format | Article |
| id | doaj-art-cce3c0e6b5754c43a796e8463680878d |
| institution | Kabale University |
| issn | 1471-2407 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
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| series | BMC Cancer |
| spelling | doaj-art-cce3c0e6b5754c43a796e8463680878d2025-02-09T12:41:21ZengBMCBMC Cancer1471-24072025-02-0125111010.1186/s12885-025-13518-0Real-world outcomes of maintenance therapy post-autologous stem cell transplantation in newly diagnosed multiple myelomaKa-Won Kang0Dae Sik Kim1Se Ryeon Lee2Mi Hwa Heo3Hyeon-Seok Eom4Jongheon Jung5Ji Hyun Lee6Sung-Hyun Kim7Youngil Koh8Chang-Ki Min9Seung Shin Lee10Sung-Nam Lim11Ho-Young Yhim12Myung-won Lee13Je-Jung Lee14Sung-Hoon Jung15Soo-Mee Bang16Kihyun Kim17the Korean Multiple Myeloma Working party [KMMWP]Division of Hematology-Oncology, Department of Internal Medicine, Korea University College of MedicineDivision of Hematology-Oncology, Department of Internal Medicine, Korea University Guro HospitalDivision of Hematology-Oncology, Department of Internal Medicine, Korea University Ansan HospitalDivision of Hemato-Oncology, Department of Internal Medicine, Dongsan Medical Center, Keimyung University School of MedicineDepartment of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer CenterDepartment of Hematology-Oncology, Center for Hematologic Malignancy, National Cancer CenterDivision of Hematology-Oncology, Department of Internal Medicine, Dong-A University College of MedicineDivision of Hematology-Oncology, Department of Internal Medicine, Dong-A University College of MedicineDivision of Hematology-Oncology, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of MedicineHematology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of KoreaDepartment of Hematology-Oncology, Wonkwang University HospitalDepartment of Internal Medicine, Inje University College of Medicine, Haeundae Paik HospitalDivision of Hematology/Oncology, Department of Internal Medicine, Jeonbuk National University Medical SchoolDivision of Hematology and Oncology, Department of Internal Medicine, Chungnam National University HospitalDepartment of Hematology-Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical SchoolDepartment of Hematology-Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical SchoolDivision of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of MedicineDivision of Hematology-Oncology, Department of Medicine, Sungkyunkwan University School of Medicine, Samsung Medical CenterAbstract Background In the Republic of Korea, only lenalidomide, bortezomib, ixazomib, and thalidomide monotherapy are available as maintenance therapy post-autologous stem cell transplantation (ASCT). Methods To determine whether maintenance therapy confers a survival benefit in the real world, we compared treatment outcomes according to the use and type of maintenance therapy in patients who underwent ASCT following frontline therapy with the triplet regimen of bortezomib, thalidomide, and dexamethasone for newly diagnosed multiple myeloma in 15 nationwide centers. Results A total of 512 patients were analyzed (no-maintenance group, n = 359, and maintenance group, n = 153 patients). Among those receiving maintenance therapy, 104 (68%) received thalidomide, 33 (21%) lenalidomide, and 16 (10%) bortezomib or ixazomib. The median progression-free survival (PFS) from the time of ASCT was 26.4 and 44.1 months in the no-maintenance and maintenance groups, respectively. In the multivariate analysis, the use of maintenance therapy was significantly associated with better PFS. After adjustment for the type and duration of maintenance therapy, the use of bortezomib or ixazomib was associated with better PFS than other drugs. Longer duration of therapy was associated with improved PFS. No statistically significant difference was observed in overall survival and secondary malignancy rates by use or type of maintenance. Conclusion Despite practical limitations, maintenance therapy after ASCT demonstrated a gain in PFS in the real world, and there was no clear increase in the risk of secondary malignancy. Therefore, it may be prudent to consider implementing maintenance therapy in a feasible manner.https://doi.org/10.1186/s12885-025-13518-0Multiple myelomaAutologous stem cell transplantationMaintenanceThalidomideLenalidomideBortezomib |
| spellingShingle | Ka-Won Kang Dae Sik Kim Se Ryeon Lee Mi Hwa Heo Hyeon-Seok Eom Jongheon Jung Ji Hyun Lee Sung-Hyun Kim Youngil Koh Chang-Ki Min Seung Shin Lee Sung-Nam Lim Ho-Young Yhim Myung-won Lee Je-Jung Lee Sung-Hoon Jung Soo-Mee Bang Kihyun Kim the Korean Multiple Myeloma Working party [KMMWP] Real-world outcomes of maintenance therapy post-autologous stem cell transplantation in newly diagnosed multiple myeloma BMC Cancer Multiple myeloma Autologous stem cell transplantation Maintenance Thalidomide Lenalidomide Bortezomib |
| title | Real-world outcomes of maintenance therapy post-autologous stem cell transplantation in newly diagnosed multiple myeloma |
| title_full | Real-world outcomes of maintenance therapy post-autologous stem cell transplantation in newly diagnosed multiple myeloma |
| title_fullStr | Real-world outcomes of maintenance therapy post-autologous stem cell transplantation in newly diagnosed multiple myeloma |
| title_full_unstemmed | Real-world outcomes of maintenance therapy post-autologous stem cell transplantation in newly diagnosed multiple myeloma |
| title_short | Real-world outcomes of maintenance therapy post-autologous stem cell transplantation in newly diagnosed multiple myeloma |
| title_sort | real world outcomes of maintenance therapy post autologous stem cell transplantation in newly diagnosed multiple myeloma |
| topic | Multiple myeloma Autologous stem cell transplantation Maintenance Thalidomide Lenalidomide Bortezomib |
| url | https://doi.org/10.1186/s12885-025-13518-0 |
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