Complications of Autologous Stem Cell Transplantation in Multiple Myeloma: Results from the CALM Study
Anna Waszczuk‐Gajda, Olaf Penack, Giulia Sbianchi, Linda Köster, Didier Blaise, Péter Reményi, Nigel H. Russell, Per Ljungman, Marek Trněný, Jiřı́ Mayer, Simona Iacobelli, Guido Kobbe, Christof Scheid, Jane F. Apperley, Cyrille Touzeau, Stig Lenhoff, Esa Jantunen, Αchilles Anagnostopoulos, Laura París, Paul Browne, Catherine Thiéblemont, Nicolaas Schaap, Jorge Sierra, Ibrahim Yakoub‐Agha, Laurent Garderet, Jan Styczyński, Hélène Schoemans, Ivan Moiseev, Rafael F. Duarte, Zinaida Perić, Silvia Montoto, Anja van Biezen, Małgorzata Mikulska, Mahmoud Aljurf, Tapani Ruutu, Nicolaus Kröger, Curly Morris, Christian Koenecke, Stefan Schoenland, Grzegorz Basak
Abstract
Background: The main goal of this post hoc analysis of the Collaboration to Collect Autologous Transplant Outcomes in Lymphoma and Myeloma (CALM) study was to evaluate the rate of short- and long-term infectious and non-infectious complications occurring after ASCT in patients with multiple myeloma (MM). Methods: The analysis included all patients with MM from the CALM study who underwent ≥1 ASCT. The primary endpoint of the analysis was to determine the rate of infectious and non-infectious complications after ASCT and to compare them in three time periods: 0−100 days, 101 days−1 year, and >1 year after the first transplant. Results: The analysis included a total of 3552 patients followed up for a median of 56.7 months (range 0.4−108.1). Complication rates decreased with the time from ASCT with 24.85 cases per 100 patient-years from day 0 to 100 days after the transplant, and <2.31 cases per 100 patient-years from the 101st day. At 100 days after ASC T, 45.7% of patients had complications, with infectious events being twice as frequent as non-infectious complications. Bacterial infections (6.5 cases per 100 patient-years, 95% CI: 6.1−7.0) and gastrointestinal complications (4.7 cases per 100 patient-years, 95% CI: 4.3−5.1) were the most common early events. The pattern of complications changed with time from ASCT. The presence of complications after ASCT was not associated with overall survival. Conclusions: Our data provide a solid basis for comparing ASCT-related complications to those caused by emerging treatments in multiple myeloma, such as CAR T-cell therapy and other immunotherapies.