Pretreatment hemoglobin, myeloma subtype, and induction regimens as independent prognostic factors for survival after autologous stem cell transplantation in multiple myeloma: a retrospective cohort study

Autologous hematopoietic stem cell transplantation (auto-HSCT) is standard for eligible multiple myeloma (MM) patients, yet outcomes are heterogeneous. Besides established markers like cytogenetics and ISS, the independent prognostic value of pretreatment hemoglobin (Hb), myeloma subtype, and induct...

Full description

Saved in:
Bibliographic Details
Published in:Hematology (Luxembourg) Vol. 30; no. 1; p. 2566570
Main Authors: Zhang, Yong, Yang, Guangzhong, Gao, Wen, Chen, Wenming
Format: Journal Article
Language:English
Published: England Taylor & Francis Group 01.12.2025
Subjects:
Adult
Aged
autologous stem cell transplantation
bortezomib
Bortezomib - therapeutic use
Female
Hematopoietic Stem Cell Transplantation - methods
hemoglobin
Hemoglobins - analysis
Hemoglobins - metabolism
Humans
Male
Middle Aged
Multiple myeloma
Multiple Myeloma - blood
Multiple Myeloma - mortality
Multiple Myeloma - therapy
Prognosis
progression-free survival
Retrospective Studies
Transplantation, Autologous
bortezomib
progression-free survival
hemoglobin
Multiple myeloma
autologous stem cell transplantation
ISSN:1607-8454, 1607-8454
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Autologous hematopoietic stem cell transplantation (auto-HSCT) is standard for eligible multiple myeloma (MM) patients, yet outcomes are heterogeneous. Besides established markers like cytogenetics and ISS, the independent prognostic value of pretreatment hemoglobin (Hb), myeloma subtype, and induction regimen requires clarification. This study aimed to assess these factors to improve risk stratification. We retrospectively analyzed 350 MM patients undergoing first auto-HSCT at Beijing Chao-Yang Hospital (2001-2019). The impact of baseline Hb (<10 vs. ≥10 g/dL), subtype (IgG vs. non-IgG), and induction regimen (bortezomib-based vs. others) on progression-free survival (PFS) and overall survival (OS) was evaluated using Kaplan-Meier and Cox regression. With a median follow-up of 58 months, median PFS and OS were 42 months (95% CI 36-48) and 98 months (95% CI 83-113), respectively. Multivariate analysis identified three independent predictors of superior PFS: Hb ≥10 g/dL (HR = 0.65, = 0.012), IgG subtype (HR = 0.72, = 0.018), and bortezomib-based induction (HR = 0.58, = 0.004). Attaining CR/VGPR post-transplant also significantly prolonged PFS versus PR or less (median 55 vs. 37 months, = 0.044). Pretreatment hemoglobin, IgG subtype, and bortezomib-based induction are independent predictors of survival after auto-HSCT. Hb, a simple and widely available marker, adds prognostic value beyond ISS and cytogenetics. Integrating these factors into prognostic models can help tailor therapy and improve patient management.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:1607-8454
1607-8454
DOI:10.1080/16078454.2025.2566570