Table 1. Prognostic impact of response level in patients with newly diagnosed multiple myeloma: transplant studies.

Reference  Response criteria  Study type	Treatment	Response		n	PFS/TTP/EFS (median, moa/rate, %)			OS (median, moa/rate, %)
					mEFS	5 yr	P-value	mOS	5 yr	P-value
Lahuerta et al.26  mEBMT  Prospective	GEM2000→HD-SCT→IFN+prednisone (maint)	Post induction	CR nCR PR SD PD	101 96 346 63 26	56 47 43 41 20	53 49 34 33 12	0.05 CR versus PR	NR NR NR NR 25	78 65 63 56 25	0.02 CR versus SD
		Post transplant	CR nCR PR SD PD	278 124 175 30 25	61 40 34 44 13	52 27 23 27 4	<0.01 CR versus nCR, PR and SD	NR NR 61 NR 15	74 63 50 57 24	⩽0.01 CR versus nCR, PR, and SD; 0.04 nCR versus PR
					PFS	4 yr	P-value	OS	4 yr	P-value
Dytfeld et al.114  mEBMT  Phase 2	VDD±SCT VDD+SCT (subgroup)	Post induction Post induction	⩾VGPR <VGPR ⩾VGPR <VGPR	25 15 16 14	— —	67.2 46.3 77.8 53.8	0.08 0.036	— —	86.5 58.2 92.9 64.3	0.04 0.027
					mPFS		P-value	mOS		P-value
Gertz et al.115  Retrospective	T or R regimen→SCT	Post induction	PR <PR	232 54	22.1 13.1		<0.001	73.5 30.4	—	<0.001
Moreau et al.27  mEBMT  Ph 3 post hoc	VD or VAD ±DCEP→SCT	Post induction	⩾VGPR <VGPR	125 357	41.2 29.0		<0.0001	—	—	—
					mEFS	5 yr	P-value	OS	5 yr	P-value
Harousseau et al.28  EBMT  Pooled analysis  (2 prospective studies)	VAD→double SCT→no treatment, Pam or Pam+T	Post transplant	⩾VGPR <VGPR	445 288	42 32	34 26	0.005	—	74 61	0.0017
								mOSb	4 yrc	P-value
Kapoor et al.116  IMWG  Retrospective	SCT	Post transplant	sCR CR nCR	115 28 46	—	—	—	NR 59 53	86 60 —	0.007
								mOS	4 yr	P-value
Barlogie et al.57  EBMT  Retrospective	TT2 TT1 Tandem SCT	36-mo landmark 36-mo landmark 36-mo landmark	Sust-CR Non-CR Lost-CR Sust-CR Non-CR Lost-CR Sust-CR Non-CR Lost-CR	256 211 39 44 88 33 197 252 60	—	—	—	NR 67.2 19.2 127.2 72 34.8 76.8 46.8 21.6	83 59 19 — — — — — —	<0.0001 Sust-CR versus non-CR and <0.0001 versus lost-CR; <0.0001 non-CR versus lost-CR 0.06 Sust-CR versus non-CR and 0.001 versus lost-CR; 0.04 <0.0001 Sust-CR versus non- CR/lost-CR; 0.0002 non- CR versus lost-CR
					mPFS		P-value	mOS		P-value
Alegre et al.117  Observational	HD-ASCT±IFN-α maint	Post induction	CR PR SD PD	56 153 25 25	35 28 20 8	—	0.001 CR/PR versus SD/PD	39 36 24 12	—	0.001 CR/PR versus SD/PD
					EFS	5 yr	P-value	OS	5 yr	P-value
Galli et al. 29  mEBMT  Observational	TT1	Post induction Post ASCT1 Post ASCT2	CR ⩾VGPR PR/SD SD CR <VGPR CR <VGPR	17 29 81 18 43 53 51 28	—	65 54 24 27 32 30 33 34	0.025 CR versus <CR 0.006 ⩾VGPR versus PR/SD	—	63 63 47 56 50 58 59 63	0.31 CR versus <CR

Abbreviations: DCEP, dexamethasone, cyclophosphamide, etoposide, and cisplatin; GEM2000, induction therapy with six alternating 5-week cycles of vincristine, carmustine, cyclophosphamide, melphalan and prednisone/vincristine, carmustine, doxorubicin and dexamethasone→HD-SCT; HD-ASCT, high-dose therapy with autologous stem cell transplant; IFN, interferon; IMWG, International Myeloma Working Group; maint, maintenance therapy; mEBMT, modified European Group for Blood and Marrow Transplantation; mEFS, median event-free survival; mOS, median overall survival; mPFS, median progression-free survival; nCR, near complete response; NR, not reached; Pam, pamidronate; PD, progressive disease; R, lenalidomide; sCR, stringent complete response; SCT, stem cell transplant; SD, stable disease; Sust, sustained; T, thalidomide; TT; total therapy; VAD, vincristine, doxorubicin, dexamethasone; VD, bortezomib, dexamethasone; VDD, bortezomib, pegylated liposomal doxorubicin, dexamethasone; VGPR, very good partial response; yr, years.

^aConversion to months for studies reporting other time increments.

^bFrom diagnosis P=0.0004.

^cFrom SCT.