Impact of high serum lactate dehydrogenase in multiple myeloma in upfront autologous stem cell transplantation in the era of new drugs: A single institute experience

Abstract

We retrospectively analyzed the clinical outcomes and prognostic factors of 26 newly-diagnosed multiple myeloma (MM) patients treated with bortezomib (BTZ)-containing induction therapy prior to HDT/ASCT (BTZ group). Twenty-six patients who were not treated with BTZ were used as a historical control (control group). Compared with the historical controls, median progression-free survival (PFS) of the BTZ group was significantly longer (48.5 M vs. 21.4 M), while the median overall survival (OS) was not (not achieved vs. 76.9 M). Both post-induction- and post-ASCT-response rates were significantly better in the BTZ group compared with the controls. Multivariate analyses revealed that a high serum LDH level at diagnosis was associated with both shorter PFS and OS. The introduction of new drugs before auto-SCT improved the clinical response and PFS but did not improve OS. High LDH at diagnosis is an independent poor prognostic factor in the setting of HDT/ASCT even in the era of new drugs.