ASH 2024 | The trends in outcomes after upfront autoSCT for multiple myeloma over three decades

These types of studies have been done for other diseases also and people have looked at that, that what has been the natural course of a certain disease over the number of years, especially with the availability of better diagnostic tests, earlier treatment, better treatment options, more treatment options, better access to healthcare. So again, we looked at our data set from 1988 to 2021 and we had more than 3,000 patients in the data set who all had an autologous stem cell transplant at our center after their initial treatment. And we divided them into five different periods from 1988 to 2000 and then in increments of five years from that period on until 2021. And basically to summarize, there are a lot of data and numbers that what we saw was that although with time, like in the more recent period, the patients who are being transplanted are much older than what we did earlier on and they are sicker in terms of comorbidity indices which identify how sick a patient is or what other medical conditions they have. So patients who were transplanted more recently were older and sicker but our treatment-related mortality was much lower now than what it used to be earlier on perhaps because of better supportive care, better patient selection – less than one percent. We also saw better response rates, which is expected because we have better drugs to treat myeloma, and not only that, there was a significant improvement in their progression-free survival, which in the first 12 or 13 years used to be about two years or less, had increased to five years and is improving even further. And similarly, the overall survival earlier on, it was four and a half years, and now the projection is that it is going to be well above a decade. So basically showing that over the last three and a half decades, we have made significant progress. And although we are treating older and sicker patients, their outcomes are still dramatically better than when you compare them to patients who were treated say 25, 30, 35 years ago. So that is the gist of that analysis that had, of course, a lot of patients and a lot of work. Went into that, my colleague Oren Pozwalski, who is an assistant professor in the department of lymphoma and myeloma, did a heroic amount of work, basically, to put together these data.

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