Analysis of long-term survival in multiple myeloma after first-line autologous stem cell transplantation: impact of clinical risk factors and sustained response.

Older age (HR 1.15, P = 0.01) and thrombocytopenia <150.000/ μ L (HR 1.48, P = 0.02) at diagnosis were significant risk factors, a negative trend was seen for ISS stage 3 (HR 1.30, P = 0.07).

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Subgroup analysis of different modalities of maintenance therapy showed that maintenance therapy with interferon α had a pronounced positive impact on PFS (HR 0.47, P < 0.001) and OS (HR 0.42, P < 0.001), while novel agent based maintenance, largely consisting of thalidomide, failed to reach statistical significance (PFS: P = 0.08; OS: HR 0.80, P = 0.34), see Figure S2.

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Assessment of conditional survival showed a trend toward improving prognosis over time, however, no minimal survival time of prognostic value for long‐term survival could be identified indicating a persisting risk of MM associated death even more than 15 years following ASCT.

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Landmark analyses performed at 1, 3, and 5 years post‐ASCT revealed that sustainment of any response had a highly significant influence on survival with no significant differences between sustained CR and sustained inferior responses.

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While there seemed to be a slight trend towards improved conditional survival over time, no specific minimal survival time of prognostic value for long‐term survival could be defined (Fig. 3 , suppl.

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