Abstract
BACKGROUND: An induction regimen, followed by autologous stem cell transplantation (ASCT) and subsequent maintenance therapy, is a standard practice for patients with newly diagnosed multiple myeloma (MM) who are eligible for transplantation. The effectiveness of short-term consolidation regimens following ASCT remains ambiguous and is not yet incorporated into MM guidelines. METHODS: This study consecutively enrolled patients with MM who had a bortezomib-based induction regimen prior to ASCT. A total of one hundred twelve patients who achieved at least a partial response at two months post-autologous stem cell transplantation were studied [median age: 59 (30-74) years; male/female ratio: 60/52]. RESULTS: Twenty-five patients did not undergo any consolidation, whereas eighty-seven patients got a median of 2 cycles (range: 1-6) of cyclophosphamide-bortezomib-dexamethasone (CyBorD) for Bortezomib-Lenalidomide-Dexamethasone (VRD) consolidation following ASCT. Progression-free survival (PFS) in the overall trial cohort was longer in patients receiving consolidation therapy (57 months versus 44 months, p = 0.06). Among patients exhibiting a very good partial response (VGPR) or partial response (PR) to ASCT, PFS was markedly prolonged in those who underwent consolidation cycles compared to those who did not (57 vs. 12 months; p = 0.04). Conversely, in the stringent complete remission (sCR) or complete remission (CR) cohort, PFS did not differ between patients who received consolidation cycles and those who did not. The analysis revealed no statistically significant differences in overall survival (OS) between the two answer category groups (p > 0.05). The PFS (p > 0.05) and incidence of severe toxicity (p > 0.05) were comparable for patients receiving CyBorD and VRD consolidation regimens. CONCLUSIONS: Our study demonstrated that consolidation therapy is safe regarding its adverse effect profile, and that its beneficial impact on PFS in first-line treatment is particularly evident in patients exhibiting VGPR and PR to ASCT.