Stage B multiple myeloma patients: a long-term, single center outcomes research study

Abstract

The major determinants of treatment response were analyzed in 71 newly diagnosed stage B multiple myeloma (MM) patients, whose treatment allocation was based on age and performance status but not on serum creatinine. Forty-one patients entered programs of high-dose therapy (HDT) with autotransplantation (autoTx), while the other 30 received non-autoTx-based therapies. At the end of the treatment program, serum creatinine returned below 2 mg/dl in 65% of patients. The median overall survival (OS) and event-free survival (EFS) of the 41 patients who entered programs of HDT were 32 and 26 months, respectively, which increased to 41 and 32 months for the 28 patients who received at least one autoTx. The other 30 patients allocated to non autoTx-based therapies had median OS and EFS of 17 and 14 months. Overall, 60% of patients reached at least a partial response. Requirement of dialysis at diagnosis was the strongest independent predictor of worse OS and EFS. Anemia, hypercalcemia and Bence Jones positive proteinuria were adverse predictors of EFS. In conclusion, an appropriate treatment of stage B-MM patients allows restoring a normal renal function in the majority of the cases. When feasible, HDT and autoTx represent an important treatment option also for these patients.