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000132496 1001_ $$00000-0002-9615-2564$$aLehners, Nicola$$b0$$eFirst author
000132496 245__ $$aAnalysis of long-term survival in multiple myeloma after first-line autologous stem cell transplantation: impact of clinical risk factors and sustained response.
000132496 260__ $$aHoboken, NJ$$bWiley$$c2018
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000132496 520__ $$aThe widespread use of high-dose therapy and autologous stem cell transplantation (ASCT) as well as the introduction of novel agents have significantly improved outcomes in multiple myeloma (MM) enabling long-term survival. We here analyze factors influencing survival in 865 newly diagnosed MM patients who underwent first-line ASCT at our center between 1993 and 2014. Relative survival and conditional survival were assessed to further characterize long-term survivors. Achievement of complete response (CR) post-ASCT was associated with prolonged progression-free survival (PFS) in the whole cohort and with significantly superior overall survival (OS) in the subgroup of patients receiving novel agent-based induction therapy. Landmark analyses performed at 1, 3, and 5 years post-ASCT revealed that sustainment of any response had a highly significant influence on survival with no significant differences between sustained CR and sustained inferior responses. Furthermore, outcome was independently improved by administration of maintenance therapy. A subset of patients did experience long-term survival >15 years. However, conditional survival demonstrated a persistent risk of myeloma-associated death and cumulative relative survival curves did not show development of a clear plateau, even in prognostically advantageous groups. In conclusion, in this large retrospective study, sustained response after first-line ASCT was found to be a major prognostic factor for OS independent of depth of sustained response. Administration of maintenance therapy further improved outcome, supporting the hypothesis that interventions to prolong responses achieved post-ASCT may be essential to reach long-term survival, especially in the setting of persisting residual disease.
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000132496 7001_ $$0P:(DE-He78)ecb33fb615e08035fdcefcaebfdff8f0$$aBecker, Natalia$$b1
000132496 7001_ $$0P:(DE-He78)e15dfa1260625c69d6690a197392a994$$aBenner, Axel$$b2
000132496 7001_ $$aPritsch, Maria$$b3
000132496 7001_ $$aLöpprich, Martin$$b4
000132496 7001_ $$aMai, Elias Karl$$b5
000132496 7001_ $$0P:(DE-He78)7ccc574e713526d2a22d7acb9b2248c5$$aHillengass, Jens$$b6$$udkfz
000132496 7001_ $$aGoldschmidt, Hartmut$$b7
000132496 7001_ $$0P:(DE-He78)1cb537e833afd985097ccfaddffb2ef3$$aRaab, Marc-Steffen$$b8$$eLast author
000132496 773__ $$0PERI:(DE-600)2659751-2$$a10.1002/cam4.1283$$gVol. 7, no. 2, p. 307 - 316$$n2$$p307 - 316$$tCancer medicine$$v7$$x2045-7634$$y2018
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000132496 9141_ $$y2018
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