ArticleBMC cancer2024
Real-world advantage and challenge of post-autologous stem cell transplantation MRD negativity in high-risk patients with double-hit multiple myeloma.
Article in BMC cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 7 citations in OpenAlex.
- Outcomes Among MM Patients Receiving Early Intervention for MRD Progression Following Autologous Stem Cell Transplantation.Cancer medicine · 2026Article
- Outcomes of Double-Hit and Single High-Risk Cytogenetic Newly Diagnosed Myeloma in Transplant-Eligible Patients.Current oncology (Toronto, Ont.) · 2026Article
- Clinical Practice of Treatment Switch in Transplant-eligible Patients with Multiple Myeloma: An Exploratory Retrospective Analysis.Internal medicine (Tokyo, Japan) · 2026Article
- Treatment patterns, effectiveness, and safety of daratumumab-based regimens in Chinese patients with multiple myeloma: longer follow-up of the real-world MMY4032 study.Annals of hematology · 2026Observational
- Evidence for the Monitoring of Minimal Residual Disease Dynamics to Guide Clinical Practice in Patients with Multiple Myeloma.Targeted oncology · 2026Review
- [Clinical characteristics, treatment, and prognosis of double-hit multiple myeloma with concurrent 1q21+ and t (4;14)].Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi · 2026Article
- Guidelines and consensus for minimal residual disease-adapted therapy in multiple myeloma from the Pan-Pacific multiple myeloma working group.Clinical hematology international · 2026Article
- Article
- Tandem autologous stem cell transplant in multiple myeloma patients with minimal residual disease: an explorative study.Blood research · 2025Article
- Article
- Exploring secondary extramedullary myeloma disease: a five-predictor scoring system with spotlight on double-hit cytogenetics.BMC medicine · 2025Article
- Cytogenetic risk stratification combined with minimal residual disease status influences the therapeutic outcome and prognosis of multiple myelomas.Scientific reports · 2025Article
- Real-World Evidence on Prognostic Value of MRD in Multiple Myeloma Using Flow Cytometry.European journal of haematology · 2025Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundAutologous stem-cell transplantation (ASCT) remains a beneficial approach for patients with newly diagnosed multiple myeloma (NDMM) in the age of novel therapeutic agents. Nevertheless, limited real-world data is available to establish criteria for identifying high-risk ASCT patients.
methodsWe analyzed outcomes for 168 NDMM patients who underwent ASCT at our center from December 2015 to December 2022. We investigated the impact of the number of high-risk cytogenetics (HRCA), defined as t(4;14), t(14;16), 1q21 gain/amplification, and del(17p), as well as the post-ASCT minimal residual disease (MRD) status as prognostic indicators. We assessed progression-free survival (PFS) and overall survival (OS), and focused on identifying risk factors.
resultsThe cohort included 42% of patients (n = 71) with 0 HRCA, 42% (n = 71) with 1 HRCA, and 16% (n = 26) with ≥ 2 HRCA. After a median follow-up of 31 months, the median PFS was 53 months (95% CI, 37-69), and OS was not reached for the entire cohort. Despite similar rates of MRD-negativity post-ASCT, patients with ≥ 2 HRCA, termed "double hit" (DH), had a significantly higher risk of progression/mortality than those with 0 or 1 HRCA. Multivariate analysis highlighted DH (HR 4.103, 95% CI, 2.046-8.231) and MRD positivity post-ASCT (HR 6.557, 95% CI, 3.217-13.366) as adverse prognostic factors for PFS, with DH also linked to inferior OS. As anticipated, DH patients with post-ASCT MRD positivity displayed the poorest prognosis, with a median PFS of 7 months post-ASCT. Meanwhile, DH patients with MRD negativity post-ASCT showed improved prognosis, akin to MRD-negative non-DH patients. It is noteworthy to exercise caution, as DH patients who initially achieved MRD negativity experienced a 41% cumulative loss of that status within one year.
conclusionsThis study strongly advocates integrating DH genetic assessments for eligible ASCT patients and emphasizes the importance of ongoing MRD monitoring, as well as considering MRD-based treatment adaptation for those patients in real-world settings.
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