Prognostic Impact on Survival of Early Relapse after Autologous Stem Cell Transplantation with Non-cryopreserved Stem Cells for Multiple Myeloma in Real Life: A Single-center Cohort Study from Oran (Algeria)

Background: The aim of this retrospective study was to analyze early relapse in multiple myeloma (MM) in real life and to evaluate its impact on overall survival (OS) and progression-free survival (PFS). Methods: Two groups of patients were identified according to the date of occurrence of relapse after autologous transplantation, within less than 24 months, defining early relapse (G1), or after more than 24 months, defining late relapse (G2). Results: A total of 307 patients with MM were enrolled, including 93 patients (30%) who had experienced relapse. There were 56 early relapses (18%) and 37 late relapses (12%). In G1 the median follow-up was 19.5 months (3-93), as compared to59 months (24-117) in G2. The median of PFS was 18 months (14.8-21.14) in G1 and was not attained in G2 (p=0.0001). The median of OS was 29 months (18.2-39.7) in G1 and was not attained in G2 (p=0.0001). In a univariate analysis, age>60 years (p=0.003), performance status>1 (p=0.036), LDH>normal (p=0.002), ISS III (p=0.0002) and an absence of maintenance therapy (p=0.002) were found to be predictive factors for early relapse. In a multivariate analysis, only a delay from the initiation of treatment to ASCT of>12 months (p=0.02) and an absence of maintenance therapy (p=0.002) were predictive of early relapse. Conclusion: The predictive factors identified here should allow us to adapt the therapeutic strategy.