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00925njm 22002777a 4500 dc Lopez-Corral, Lucia author Caballero-Velazquez, Teresa author Lopez-Godino, Oriana author Rosinol, Laura author Perez-Vicente, Sabina author Fernandez-Aviles, Francesc author Krsnik, Isabel author Morillo, Daniel author Heras, Inmaculada author Morgades, Mireia author Rifon, Jose J author Sampol Mayol, Antonia author Iniesta, Francisca author Ocio, Enrique-Maria author Martin, Jesus author Rovira, Montserrat author Cabero, Martin author Castilla-Llorente, Cristina author Ribera, Josep-Maria author Torres-Juan, Marta author Maria Moraleda, Jose author Martinez, Carmen author Vazquez, Alejandro author Gutierrez, Gonzalo author Caballero, Dolores author San Miguel, Jesus F author Mateos, Maria-Victoria author Perez-Simon, Jose Antonio author 2019-09 Multiple myeloma (MM) remains as an incurable disease and, although allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a potentially curative approach, most patients ultimately relapse, and their treatment remains challenging. Because allo-HSCT can modify not only the biology of the disease, but also the immune system and the microenvironment, it can potentially enhance the response to rescue therapies. Information on the efficacy and safety of novel drugs in patients relapsing after allo-HSCT is lacking, however. The objectives of this study were to evaluate the efficacy and toxicity of rescue therapies in patients with MM who relapsed after allo-HSCT, as well as to compare their efficacy before and after allo-HSCT. This retrospective multicenter study included 126 consecutive patients with MM who underwent allo-HSCT between 2000 and 2013 at 8 Spanish centers. All patients engrafted. The incidence of grade II-IV acute graft-versus-host disease (GVHD) was 47%, and nonrelapse mortality within the first 100 days post-transplantation was 13%. After a median follow-up of 92 months, overall survival (OS) was 51% at 2 years and 43% at 5 years. The median progression-free survival after allo-HSCT was 7 months, whereas the median OS after relapse was 33 months. Patients relapsing in the first 6 months after transplantation had a dismal prognosis compared with those who relapsed later (median OS, 11 months versus 120 months; P < .001). The absence of chronic GVHD was associated with reduced OS after relapse (hazard ratio, 3.44; P < .001). Most patients responded to rescue therapies, including proteasome inhibitors (PIs; 62%) and immunomodulatory drugs (IMiDs; 77%), with a good toxicity profile. An in-depth evaluation, including the type and intensity of PI- and IMiD-based combinations used before and after allo-HSCT, showed that the overall response rate and duration of response after allo-HSCT were similar to those seen in the pretransplantation period. Patients with MM who relapse after allo-HSCT should be considered candidates for therapy with new drugs, which can achieve similar response rates with similar durability as seen in the pretransplantation period. This pattern does not follow the usual course of the disease outside the transplantation setting, where response rates and time to progression decreases with each consecutive line of treatment. Lopez-Corral L, Caballero-Velazquez T, Lopez-Godino O, Rosinol L, Perez-Vicente S, Fernandez-Aviles F, et al. Response to Novel Drugs before and after Allogeneic Stem Cell Transplantation in Patients with Relapsed Multiple Myeloma. Biol Blood Marrow Transplant. 2019 Sep;25(9):1703-12. Epub 2019 May 3. 10.1016/j.bbmt.2019.04.026 1523-6536 1083-8791 Biology of Blood and Marrow Transplantation http://hdl.handle.net/20.500.13003/17259 31054983 L2002091185 2-s2.0-85067067293 https://hdl.handle.net/20.500.12105/22690 488887800001 Multiple myeloma Allogeneic hematopoietic stem cell transplantation Allo-HSCT Proteasome inhibitor Immunomodulatory drug Response to Novel Drugs before and after Allogeneic Stem Cell Transplantation in Patients with Relapsed Multiple Myeloma