Outcomes among high-risk and standard-risk multiple myeloma patients treated with high-dose chemotherapy and autologous hematopoietic stem-cell transplantation

Syed M. Kazmi, Maliha Nusrat, Hilal Gunaydin, Amanda M. Cornelison, Nina Shah, Partow Kebriaei, Yago Nieto, Simrit Parmar, Uday R. Popat, Betul Oran, Jatin J. Shah, Robert Z. Orlowski, Richard E. Champlin, Muzaffar H. Qazilbash, Qaiser Bashir

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background Conventional cytogenetics and interphase fluorescence in-situ hybridization (FISH) identify a high-risk multiple myeloma population characterized by poor response and short survival. Patients and Methods We compared outcomes between high-risk and standard-risk myeloma patients who underwent autologous hematopoietic stem-cell transplantation (auto-HCT) at our institution between January 2005 and December 2009. High-risk myeloma was defined as -13/del(13q) or hypodiploidy in at least 2 metaphases of conventional cytogenetics, or -17/del(17p), t(4;14), t(14;16), t(14;20), hypodiploidy (< 45 chromosomes excluding -Y), or chromosome 1 abnormalities (+1q, -1p, t(1;x)) on FISH or conventional cytogenetics. Results Of 670 myeloma patients, 74 (11%) had high-risk myeloma. These high-risk patients had significantly lower overall response rates (74% vs. 85%; P <.01), shorter median progression-free survival (10.3 vs. 32.4 months; P <.001), and shorter overall survival (28 months vs. not reached; P <.001) than the standard-risk patients. Having only 1 high-risk cytogenetic abnormality or experiencing at least very good partial remission after auto-HCT independently predicted improved progression-free survival and overall survival (P <.05) in high-risk patients. Conclusion Even in an era of novel therapies, cytogenetically identified high-risk myeloma patients have worse prognoses than standard-risk myeloma patients after auto-HCT, and having more than 1 high-risk cytogenetic abnormality further reduces survival.

Original languageEnglish (US)
Pages (from-to)687-693
Number of pages7
JournalClinical Lymphoma, Myeloma and Leukemia
Volume15
Issue number11
DOIs
StatePublished - Nov 1 2015

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Hematopoietic Stem Cell Transplantation
Multiple Myeloma
Drug Therapy
Cytogenetics
Chromosome Aberrations
Survival
Fluorescence In Situ Hybridization
Disease-Free Survival
Chromosomes, Human, Pair 1
Y Chromosome
Interphase
Metaphase
Chromosomes

Keywords

  • Cytogenetics
  • Multiple myeloma
  • Prognosis
  • Risk stratification
  • Stem-cell transplantation

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Outcomes among high-risk and standard-risk multiple myeloma patients treated with high-dose chemotherapy and autologous hematopoietic stem-cell transplantation. / Kazmi, Syed M.; Nusrat, Maliha; Gunaydin, Hilal; Cornelison, Amanda M.; Shah, Nina; Kebriaei, Partow; Nieto, Yago; Parmar, Simrit; Popat, Uday R.; Oran, Betul; Shah, Jatin J.; Orlowski, Robert Z.; Champlin, Richard E.; Qazilbash, Muzaffar H.; Bashir, Qaiser.

In: Clinical Lymphoma, Myeloma and Leukemia, Vol. 15, No. 11, 01.11.2015, p. 687-693.

Research output: Contribution to journalArticle

Kazmi, SM, Nusrat, M, Gunaydin, H, Cornelison, AM, Shah, N, Kebriaei, P, Nieto, Y, Parmar, S, Popat, UR, Oran, B, Shah, JJ, Orlowski, RZ, Champlin, RE, Qazilbash, MH & Bashir, Q 2015, 'Outcomes among high-risk and standard-risk multiple myeloma patients treated with high-dose chemotherapy and autologous hematopoietic stem-cell transplantation', Clinical Lymphoma, Myeloma and Leukemia, vol. 15, no. 11, pp. 687-693. https://doi.org/10.1016/j.clml.2015.07.641
Kazmi, Syed M. ; Nusrat, Maliha ; Gunaydin, Hilal ; Cornelison, Amanda M. ; Shah, Nina ; Kebriaei, Partow ; Nieto, Yago ; Parmar, Simrit ; Popat, Uday R. ; Oran, Betul ; Shah, Jatin J. ; Orlowski, Robert Z. ; Champlin, Richard E. ; Qazilbash, Muzaffar H. ; Bashir, Qaiser. / Outcomes among high-risk and standard-risk multiple myeloma patients treated with high-dose chemotherapy and autologous hematopoietic stem-cell transplantation. In: Clinical Lymphoma, Myeloma and Leukemia. 2015 ; Vol. 15, No. 11. pp. 687-693.
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abstract = "Background Conventional cytogenetics and interphase fluorescence in-situ hybridization (FISH) identify a high-risk multiple myeloma population characterized by poor response and short survival. Patients and Methods We compared outcomes between high-risk and standard-risk myeloma patients who underwent autologous hematopoietic stem-cell transplantation (auto-HCT) at our institution between January 2005 and December 2009. High-risk myeloma was defined as -13/del(13q) or hypodiploidy in at least 2 metaphases of conventional cytogenetics, or -17/del(17p), t(4;14), t(14;16), t(14;20), hypodiploidy (< 45 chromosomes excluding -Y), or chromosome 1 abnormalities (+1q, -1p, t(1;x)) on FISH or conventional cytogenetics. Results Of 670 myeloma patients, 74 (11{\%}) had high-risk myeloma. These high-risk patients had significantly lower overall response rates (74{\%} vs. 85{\%}; P <.01), shorter median progression-free survival (10.3 vs. 32.4 months; P <.001), and shorter overall survival (28 months vs. not reached; P <.001) than the standard-risk patients. Having only 1 high-risk cytogenetic abnormality or experiencing at least very good partial remission after auto-HCT independently predicted improved progression-free survival and overall survival (P <.05) in high-risk patients. Conclusion Even in an era of novel therapies, cytogenetically identified high-risk myeloma patients have worse prognoses than standard-risk myeloma patients after auto-HCT, and having more than 1 high-risk cytogenetic abnormality further reduces survival.",
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author = "Kazmi, {Syed M.} and Maliha Nusrat and Hilal Gunaydin and Cornelison, {Amanda M.} and Nina Shah and Partow Kebriaei and Yago Nieto and Simrit Parmar and Popat, {Uday R.} and Betul Oran and Shah, {Jatin J.} and Orlowski, {Robert Z.} and Champlin, {Richard E.} and Qazilbash, {Muzaffar H.} and Qaiser Bashir",
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T1 - Outcomes among high-risk and standard-risk multiple myeloma patients treated with high-dose chemotherapy and autologous hematopoietic stem-cell transplantation

AU - Kazmi, Syed M.

AU - Nusrat, Maliha

AU - Gunaydin, Hilal

AU - Cornelison, Amanda M.

AU - Shah, Nina

AU - Kebriaei, Partow

AU - Nieto, Yago

AU - Parmar, Simrit

AU - Popat, Uday R.

AU - Oran, Betul

AU - Shah, Jatin J.

AU - Orlowski, Robert Z.

AU - Champlin, Richard E.

AU - Qazilbash, Muzaffar H.

AU - Bashir, Qaiser

PY - 2015/11/1

Y1 - 2015/11/1

N2 - Background Conventional cytogenetics and interphase fluorescence in-situ hybridization (FISH) identify a high-risk multiple myeloma population characterized by poor response and short survival. Patients and Methods We compared outcomes between high-risk and standard-risk myeloma patients who underwent autologous hematopoietic stem-cell transplantation (auto-HCT) at our institution between January 2005 and December 2009. High-risk myeloma was defined as -13/del(13q) or hypodiploidy in at least 2 metaphases of conventional cytogenetics, or -17/del(17p), t(4;14), t(14;16), t(14;20), hypodiploidy (< 45 chromosomes excluding -Y), or chromosome 1 abnormalities (+1q, -1p, t(1;x)) on FISH or conventional cytogenetics. Results Of 670 myeloma patients, 74 (11%) had high-risk myeloma. These high-risk patients had significantly lower overall response rates (74% vs. 85%; P <.01), shorter median progression-free survival (10.3 vs. 32.4 months; P <.001), and shorter overall survival (28 months vs. not reached; P <.001) than the standard-risk patients. Having only 1 high-risk cytogenetic abnormality or experiencing at least very good partial remission after auto-HCT independently predicted improved progression-free survival and overall survival (P <.05) in high-risk patients. Conclusion Even in an era of novel therapies, cytogenetically identified high-risk myeloma patients have worse prognoses than standard-risk myeloma patients after auto-HCT, and having more than 1 high-risk cytogenetic abnormality further reduces survival.

AB - Background Conventional cytogenetics and interphase fluorescence in-situ hybridization (FISH) identify a high-risk multiple myeloma population characterized by poor response and short survival. Patients and Methods We compared outcomes between high-risk and standard-risk myeloma patients who underwent autologous hematopoietic stem-cell transplantation (auto-HCT) at our institution between January 2005 and December 2009. High-risk myeloma was defined as -13/del(13q) or hypodiploidy in at least 2 metaphases of conventional cytogenetics, or -17/del(17p), t(4;14), t(14;16), t(14;20), hypodiploidy (< 45 chromosomes excluding -Y), or chromosome 1 abnormalities (+1q, -1p, t(1;x)) on FISH or conventional cytogenetics. Results Of 670 myeloma patients, 74 (11%) had high-risk myeloma. These high-risk patients had significantly lower overall response rates (74% vs. 85%; P <.01), shorter median progression-free survival (10.3 vs. 32.4 months; P <.001), and shorter overall survival (28 months vs. not reached; P <.001) than the standard-risk patients. Having only 1 high-risk cytogenetic abnormality or experiencing at least very good partial remission after auto-HCT independently predicted improved progression-free survival and overall survival (P <.05) in high-risk patients. Conclusion Even in an era of novel therapies, cytogenetically identified high-risk myeloma patients have worse prognoses than standard-risk myeloma patients after auto-HCT, and having more than 1 high-risk cytogenetic abnormality further reduces survival.

KW - Cytogenetics

KW - Multiple myeloma

KW - Prognosis

KW - Risk stratification

KW - Stem-cell transplantation

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