OUTCOME IN TRANSPLANT ELIGIBLE PATIENTS WITH MULTIPLE MYELOMA IN LATIN AMERICA. AN INTERNATIONAL STUDY OF GELAMM.
Author(s): ,
Camila Peña
Affiliations:
Hematology,Hospital del Salvador,Santiago,Chile
,
Natalia P Schutz
Affiliations:
Hematology,Hospital Italiano de Buenos Aires,Buenos Aires,Argentina
,
Virginia Bove
Affiliations:
Hospital de Clínicas, Montevideo,Montevideo,Uruguay
,
Fiorella Villano
Affiliations:
CASMU,Montevideo,Uruguay
,
Rocío Osorio
Affiliations:
Hospital de Arica,Arica,Chile
,
Mauricio Chandía
Affiliations:
Hospital Guillermo Grant Benavente,Concepción,Chile
,
Daniela Cardemil
Affiliations:
Hospital de Punta Arenas,Punta Arenas,Chile
,
Carolina Contreras
Affiliations:
Hospital de Rancagua,Rancagua,Chile
,
Carmen G Contreras
Affiliations:
Hospital de Rancagua,Rancagua,Chile
,
Javiera Donoso
Affiliations:
Hospital Sótero del Río,Santiago,Chile
,
Marcela Espinoza
Affiliations:
Hospital San José,Santiago,Chile
,
La Rocca Gabriel
Affiliations:
Hospital de Coyhaique,Coyhaique,Chile
,
Hernán López-Vidal
Affiliations:
Hospital Barros Luco Trudeau,Santiago,Chile
,
Christine Rojas
Affiliations:
Hospital Gustavo Friecke,Viña del Mar,Chile
,
Pablo Soto
Affiliations:
Hospital de Puerto Montt,Puerto Montt,Chile
,
Paola Ochoa
Affiliations:
Instituto Alexander Fleming,Buenos Aires,Argentina
,
Patricio Duarte
Affiliations:
CEMIC,Buenos Aires,Argentina
,
Guillermina Remaggi
Affiliations:
FUNDALEU,Buenos Aires,Argentina
,
Sebastián Yantorno
Affiliations:
Hospital Italiano,La Plata,Argentina
,
Ariel Corzo
Affiliations:
Hospital de Clínicas José de San Martín,Buenos Aires,Argentina
,
Soledad Zabaljauregui
Affiliations:
Academia Nacional de Medicina,Buenos Aires,Argentina
,
Claudia Shanley
Affiliations:
Hospital Británico,Buenos Aires,Argentina
,
Sergio Lopresti
Affiliations:
Hospital Posadas,Buenos Aires,Argentina
,
Sergio Orlando
Affiliations:
Hospital Rossi,La Plata,Argentina
,
Verónica Verri
Affiliations:
IDIM,Buenos Aires,Argentina
,
Luis Quiroga
Affiliations:
Hospital Churruca,Buenos Aires,Argentina
,
Carlos Alen García
Affiliations:
Clínica 25 de Mayo,Mar del Plata,Argentina
,
Vanesa Fernández
Affiliations:
Hospital Méndez,Buenos Aires,Argentina
,
Dorotea Fantl
Affiliations:
Hospital Italiano de Buenos Aires,Buenos Aires,Argentina
Eloísa Riva
Affiliations:
Hospital de Clínicas,Montevideo,Uruguay
EHA Library. Peña C. Jun 15, 2019; 267019; PS1402
Camila Peña
Camila Peña
Contributions
Abstract

Abstract: PS1402

Type: Poster Presentation

Presentation during EHA24: On Saturday, June 15, 2019 from 17:30 - 19:00

Location: Poster area

Background
Multiple myeloma (MM) is a frequent hematologic malignancy. Despite the important advances in treatment strategies during the last decades, the gold standard remains being a proteasome inhibitor (PI)-based induction, followed by autologous stem cell transplant (ASCT).

In Latin America (LA) there is great heterogeneity in access to new drugs and ASCT, and there is scarce data regarding patient´s outcomes in the region.

Aims
The aim of this study was to describe clinical characteristics and outcomes of MM transplant eligible patients in LA countries.

Methods
Retrospective international multicenter cohort study. Unselected consecutive MM transplant- eligible patients diagnosed between 2010 and 2018 from participating centers in Chile, Argentina and Uruguay were included. Data was collected from clinical records in a standardized report form. We analyzed clinical characteristics at diagnosis and frontline therapy outcomes, including ASCT.

Transplant-eligible patients were defined as fit patients younger than 66 years old. Response to treatment was defined according to current IMWG criteria.

Statistical analysis was performed by using STATA 13.

Results
Six hundred and seventy one patients were included in the study, 282 from Chile, 258 from Argentina and 131 from Uruguay. The main characteristics are shown in Table 1. Significant differences in access to PI induction and ASCT were found between private and public institutions, with patients from the latter receiving suboptimal frontline therapy. Optimal response (sCR, CR and VGPR) was achieved in 51% of the patients in the CyBorD group, in 65% in the VTD group, and in 45% in the CTD group, the 3 main induction regimens used. Only 52% of patients finally underwent ASCT. With a median follow up of 33 months (range 1-109),  5 year overall survival (OS) was 58,4%, with a median survival of 73 months in the whole cohort. When analyzed according to induction treatment, 5 year OS was 74% for PI-based, 48% for thalidomide-based, and 23% for those not treated with novel agents (P<0,0001). In the multivariable analysis, not undergoing ASCT (p<0,001), renal failure (p=0,004), hypercalcemia (p=0,001), and achieving less than VGPR (p=0,001) response were independent factors associated with worse outcome.

Conclusion
Survival in transplant-eligible patients is lower than the “optimal” described survival in other regions. Unequal access to PI-based regimens and therefore to ASCT between public and private centers was observed. Reasons for 48% of candidates not being transplanted merit further analysis.

Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical

Keyword(s): Autologous bone marrow transplant, Bortezomib, Multiple myeloma, Thalidomide

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