Salvage Autologous Stem Cell Transplantation for Multiple Myeloma: Patient-Reported Outcomes
Posted: Tuesday, May 7, 2019
For patients with multiple myeloma who have relapsed, treatment with salvage autologous stem cell transplantation (ASCT) seemed to yield worse patient-reported outcomes when compared with nontransplantation consolidation. Sam H. Ahmedzai, MBChB, of the University of Sheffield, United Kingdom, and colleagues reported their findings form the phase III Myeloma X trial in the Journal of Clinical Oncology.
“Patients who experienced lower adverse effects after salvage ASCT had longer time to progression and overall survival, showing the need to improve symptom management peritransplantation” concluded the authors. “The small and diminishing differences in global health status and side effects of treatment need to be considered alongside the results of Myeloma X, which showed a significant benefit of salvage ASCT on [overall survival].”
A total of 288 patients with relapsing multiple myeloma were randomly assigned to receive either salvage ASCT or nontransplantation consolidation from 2008 to 2012. Pain and quality of life were measured using various instruments, including the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and myeloma-specific module.
The EORTC QLQ-C30 health status scores were favorable in the nontransplantation group 100 days after assignment (P = 0.0496), but at later time points, the difference in the groups diminished, and salvage ASCT was associated with higher scores at 2 years. Pain interference was worse in the salvage ASCT group at 6 months after assignment, and these patients reported higher pain interference with daily living for up to 2 years after treatment began. Patients reporting fewer concerns about side effects of treatment who received salvage ASCT had a longer time to disease progression than those treated with nontransplantation consolidation (hazard ratio = 0.24).
Disclosure: The study authors’ disclosure information may be found at ascopubs.org.