Real-world outcomes of tandem ASCT in newly diagnosed multiple myeloma patients with standard risk features: a single-center analysis

Abstract

Multiple myeloma (MM) is a clonal neoplastic proliferation of plasma cells that accounts for 1% of all cancers and 10–15% of hematological malignancies. Cytogenetic aberrations, detected by fluorescent in situ hybridization (FISH), directly impact prognosis and stratify patients into standard-risk and high-risk cytogenetics groups. 85% of newly diagnosed MM patients (NDMM) have standard-risk cytogenetics according to Revised International Staging System (R-ISS). Although MM remains an incurable disease for most patients, overall survival (OS) has improved significantly largely due to new drugs, including proteasome inhibitors (PI), immunomodulators (IMID) and monoclonal antibodies. Standard treatment of autologous stem cell transplant (ASCT) candidates includes an induction regimen with bortezomib-dexamethasone plus lenalidomide (VRD) or thalidomide (VTD); or quadruplet therapy adding daratumumab to VTD. Responders, then, receive intensification treatment with single or tandem ASCT followed by maintenance with lenalidomide until progression or intolerance [1, 2]. The role of tandem ASCT in patients with standard-risk cytogenetics has been poorly studied. We aimed to investigate whether a tandem ASCT approach is superior to single ASCT in NDMM patients with standard-risk cytogenetic features.