% IMPORTANT: The following is UTF-8 encoded. This means that in the presence % of non-ASCII characters, it will not work with BibTeX 0.99 or older. % Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or % “biber”. @ARTICLE{Lehners:132496, author = {N. Lehners$^*$ and N. Becker$^*$ and A. Benner$^*$ and M. Pritsch and M. Löpprich and E. K. Mai and J. Hillengass$^*$ and H. Goldschmidt and M.-S. Raab$^*$}, title = {{A}nalysis of long-term survival in multiple myeloma after first-line autologous stem cell transplantation: impact of clinical risk factors and sustained response.}, journal = {Cancer medicine}, volume = {7}, number = {2}, issn = {2045-7634}, address = {Hoboken, NJ}, publisher = {Wiley}, reportid = {DKFZ-2018-00183}, pages = {307 - 316}, year = {2018}, abstract = {The 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.}, cin = {G170 / C060}, ddc = {610}, cid = {I:(DE-He78)G170-20160331 / I:(DE-He78)C060-20160331}, pnm = {317 - Translational cancer research (POF3-317)}, pid = {G:(DE-HGF)POF3-317}, typ = {PUB:(DE-HGF)16}, pubmed = {pmid:29282899}, pmc = {pmc:PMC5806105}, doi = {10.1002/cam4.1283}, url = {https://inrepo02.dkfz.de/record/132496}, }