Autologous bone marrow transplant in standard-risk newly diagnosed multiple myeloma: A systematic review.

Authors

null

Andree Kurniawan

Internal Medicine, Faculty of Medicine, Pelita Harapan University, Jakarta, Indonesia

Andree Kurniawan , Dimas Priantono , Tubagus Djumhana Atmakusuma , Chandra Sari , Devi Astri Rivera Amelia , Deden Djatnika , Muhammad Arman Nasution , Nia Novianti Siregar , Nugraheny Prasasti Purlikasari , Farieda Ariyanti , Beta Agustia Wisman , Patricia Angel Tjhai , Angela Giselvania , Felix Wijovi , Devina Adella Halim , Rivaldo Steven Heriyanto

Organizations

Internal Medicine, Faculty of Medicine, Pelita Harapan University, Jakarta, Indonesia, Division of Hematology-Medical Oncology, Department of Internal Medicine Dr. Cipto Mangunkusumo General Hospital/Faculty of Medicine Universitas Indonesia, Jakarta Pusat, Indonesia, Indonesian Society of Hematology and Medical Oncology, Central Jakarta, Indonesia, Trainee, Hematology and Medical Oncology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia, Dharmais National Cancer Hospital, Jakarta Barat, Indonesia, Faculty of Medicine, Pelita Harapan University, Tangerang, Indonesia, Radiotherapy, Cipto Mangunkusumo Hospital-Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia

Research Funding

No funding sources reported

Background: Multiple myeloma (MM) is a hematological malignancy characterized by clonal proliferation of plasma cells. Bone marrow transplants in high-risk multiple myeloma have been a standard of care for newly diagnosed multiple myeloma (NDMM). Autologous bone marrow transplant (ABMT) has emerged as a promising therapeutic approach for standard risk of NDMM. We aim to review the existing literature on the efficacy of ABMT in standard-risk NDMM in comparison with non-transplant therapeutic approaches. Methods: We conducted a systematic search across PubMed, Google Scholar, Science Direct, and Embase for studies within the last 10 years. We included studies that compared ABMT with other therapies without any history of prior transplants in NDMM patients. We excluded studies that retrospective and case studies. We extracted firstly using PICO: standards risk NDMM, ABMT upfront therapy, progression-free survival, and toxicity. The quality of the study was assessed using the Newcastle-Ottawa scale or JADAD scale questionnaire. Results: Our search yielded 7 studies, with a total of 3728 patients in 7 randomized controlled trial studies. The endpoint was mainly progression-free survival (PFS), with others being response rates and stringent complete response (sCR). All studies consistently showed that ABMT yielded significantly better PFS and response rates in NDMM, with high-dose melphalan being the most common induction regime. ABMT resulted in relatively more severe toxic side effects compared to drugs only. However, the safety profile of ABMT is considered favorable, with manageable adverse events. Induction methods before ABMT include lenalidomide, bortezomib, dexamethasone, carfilzomib, and melphalan, with some studies reporting follow-ups on further maintenance therapy, mainly with lenalidomide. The effectivity of ABMT remains consistent regardless of the drugs used. Conclusions: ABMT is a favorable therapeutic approach for standard risk NDMM with manageable adverse effects and an acceptable safety profile. The effectivity of ABMT is regardless of the concomitant drug used.

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Abstract Details

Meeting

2024 ASCO Breakthrough

Session Type

Poster Session

Session Title

Poster Session B

Track

Thoracic Cancers,Breast Cancer,Gynecologic Cancer,Head and Neck Cancer,Hematologic Malignancies,Genetics/Genomics/Multiomics,Healthtech Innovations,Models of Care and Care Delivery,Viral-Mediated Malignancies,Other Malignancies or Topics

Sub Track

Real-World Evidence/Real-World Data

Citation

J Clin Oncol 42, 2024 (suppl 23; abstr 174)

DOI

10.1200/JCO.2024.42.23_suppl.174

Abstract #

174

Poster Bd #

G5

Abstract Disclosures