Attainment of at least a very good partial response after induction treatment is an important surrogate of longer survival for multiple myeloma

The importance of achieving a very good partial response or better (>= VGPR) after induction treatment of myeloma has traditionally only been discussed in the context of high-dose therapy with auto-SCT (HDT/auto-SCT). Of late, the advent of novel agents for induction treatment has resulted in improved CR and >= VGPR rates, which are comparable with those observed with HDT/auto-SCT. We show that in an unselected group of 179 myeloma patients with diverse baseline characteristics, and treated with different modern induction regimens within a single institution, the attainment of >= VGPR with or without HDT/auto-ASCT represents a major surrogate marker of better clinical outcomes. On the basis of a 1-year landmark survival analysis, patients achieving >= VGPR enjoy a significantly longer PFS, which translated to a longer OS. Superseding the adverse effects of advanced age, high International Staging System (ISS) stage, adverse cytogenetics and independent of the transplant status, the attainment of >= VGPR emerged as the single most significant predictor of long-term survival on multi-variate analysis. Bone Marrow Transplantation (2010) 45, 1625-1630; doi:10.1038/bmt.2010.25; published online 15 February 2010