Background: MM follows a clinical course leading to refractoriness and limited treatment options in RRMM. Aggressive NDMM needs rapid cytoreduction for disease control, which may not be possible with standard novel therapies. We report on a highly effective therapy that offers a salvage option for these patients. Methods: We searched our medical database for MM patients who received mCBAD from 2010-2016 – 28 day cycle of cyclophosphamide 350 mg/m² IV twice daily + mesna 400mg/m² IV daily (days 1-4), bortezomib 1.3 mg/m² SQ (days 1, 4, 8, 11), doxorubicin 9 mg/m² IV (days 1-4) , dexamethasone 40 mg PO daily (days 1-4, 9-12, 17-20). IMWG criteria were used for response assessment. Descriptive statistics, Fisher’s exact test, Chi-square, Wilcoxon rank sum, and Kaplan-Meier were used for statistical purposes. Results: 80 patients met the inclusion criteria. Baseline characteristics, response, adverse events, PFS/OS are summarized in Table 1. Median follow-up for the censored observations was 21.3 months (1.35 – 69.22). Conclusions: mCBAD offers excellent response rates (ORR > 90%) and favorable PFS/OS in highly refractory high risk MM. It is also an excellent salvage regimen with about half of patients undergoing subsequent transplant. Patient selection is required due high treatment related mortality.

*related to treatment, ^ best response - 59 evaluable RRMM, ASCT = autologous transplant