Overall Survival of Transplant Eligible Patients with Newly Diagnosed Multiple Myeloma: Comparative Effectiveness Analysis of Modern Induction Regimens on Outcome

Aims: Overall survival (OS) of multiple myeloma (MM) has improved remarkably over time, with a recent study reporting a 4-year OS rate of approximately 81.5% with or without upfront autologous stem cell transplantation (ASCT) in patients receiving modern therapy (Attal M, et al. N Engl J Med 2017; 376:1311-1320). However, these results may overestimate the current OS of MM in this population, since patients enrolled in clinical trials represent a highly selected group, and may not reflect outcomes in a more generalizable population of MM patients. In order to remove the selection bias inherent in clinical trial enrollment, we studied the outcome of all newly diagnosed MM patients eligible for ASCT seen at the Mayo Clinic during the time period corresponding to the IFM trial. We also performed a comparative effectiveness analysis of bortezomib, lenalidomide, dexamethasone (VRD) (the regimen used in the IFM trial) and other induction regimens used during this period at our institution.