Impact of achieving a complete response to initial therapy of multiple myeloma and predictors of subsequent outcome

Marcella Kaddoura, Moritz Binder, David Dingli, Francis K. Buadi, Martha Q. Lacy, Morie A. Gertz, Angela Dispenzieri, Prashant Kapoor, Lisa Hwa, Amie Fonder, Miriam Hobbs, Suzanne Hayman, Nelson Leung, Ronald S. Go, Yi Lin, Wilson Gonsalves, Taxiarchis Kourelis, Rahma Warsame, Robert A. Kyle, Vincent RajkumarShaji Kumar

Research output: Contribution to journalArticlepeer-review


Achievement of a complete response (CR) in multiple myeloma (MM) correlates with improvement in survival outcomes; however, its impact on prognostic variables at baseline outside of clinical trial settings is not well described. We sought to determine the impact of achieving a CR within 2 years from diagnosis, its effect on the prognostic value of fluorescence in situ hybridization (FISH) and International Staging System (ISS) risk, and examined additional predictors of outcome among those achieving a CR in a routine clinical setting. We evaluated 1869 newly diagnosed MM patients who had ≥ 2 monoclonal protein immunofixation studies in the serum and urine available within 24 months from diagnosis, categorizing those with ≥ 2 negative serum and urine immunofixations as achieving CR. With a landmark at 24 months, median progression-free survival (PFS) for CR versus non-CR patients was 29.8 versus 20.9 months (p ≤.0002); median overall survival (OS) was 104 versus 70 months (p <.0001). The impact of achieving a CR was retained after adjusting for FISH, ISS, sex, transplant status, and involved heavy chain. Baseline FISH and ISS stage were not associated with PFS or OS among patients achieving a CR. The following variables were found as predictors of inferior OS within the CR cohort: age > 75 years, male gender, hypoalbuminemia, and non-immunoglobulin G involved heavy chain. Our study confirms that achievement of CR within 2 years from diagnosis is associated with improvement in survival outcomes and neutralization of the impact of FISH and ISS risk, thereby confirming observations from the clinical trial setting among a clinical practice cohort.

Original languageEnglish (US)
Pages (from-to)267-273
Number of pages7
JournalAmerican journal of hematology
Issue number3
StatePublished - Mar 1 2022

ASJC Scopus subject areas

  • Hematology


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