Tandem Versus Single Autologous Stem Cell Transplantation for High‐Risk Multiple Myeloma in the Era of Novel Agents: A Real‐World Study of China

作者：Xuelin Dou, Juan Ren, Jiangtao Li, Xiaodan Liu, Li Bao, Yuan Chen, Peng Zhao, Yuping Zhong, Nan Peng, Lei Wen, Leqing Cao, Yang Liu, Dao-Xing Deng, Feng‐Rong Wang, Liru Wang, Hui Liu, Xiao‐Jun Huang, Xiao‐Dong Mo, Jin Lü · 发表于：Cancer Medicine · 年份：2025 · DOI：10.1002/cam4.70573 · 被引用次数：4 · 研究领域：Multiple Myeloma Research and Treatments、Acute Myeloid Leukemia Research、Chronic Myeloid Leukemia Treatments

BACKGROUND: This study compares the efficacy and safety of single autologous stem cell transplantation (ASCT) versus tandem ASCT for multiple myeloma (MM) patients in the era of novel agents. METHODS: A total of 112 high-risk MM patients were included (single ASCT, (n = 57) or tandem ASCT(n = 55) in this retrospective multicenter study. Responses and outcomes were evaluated. RESULTS: At 100 days after ASCT1 and ASCT2, 36 (63.2%) versus 45 (81.8%) patients achieved sCR/CR, 16 (28.1%) versus 7 (12.7%) patients achieved VGPR, and 5 (8.8%) versus 1 (1.8%) patient achieved PR, respectively, in the single and tandem ASCT cohorts. The 3-year cumulative incidence of non-relapse mortality and disease progression was 0% versus 7.3% (p = 0.083), and 45.8% versus 25.8% (p = 0.039), respectively, for the single and tandem ASCT cohort. The tandem ASCT cohort showed a trend of better 3-year probability of PFS (58.1% vs. 64.7%, p = 0.064) compared with the single ASCT cohort. In multivariate analysis, ultra high-risk and achieving<VGPR response after ASCT1 were associated with an inferior PFS. Ultra high-risk was also associated with an inferior OS. CONCLUSIONS: Tandem ASCT demonstrated improved outcomes compared to single ASCT in high-risk MM patients receiving triplet or quadruplet induction and maintenance therapy. However, patients with ultra high-risk cytogenetics may require innovative therapeutic approaches, as tendem ASCT does not overcome their adverse prognosis.