https://orcid.org/0009-0003-8661-9006
Key points
Outcomes of patients with MM in Jordan remain inferior to those in Western populations, due to limited access to advanced therapeutics.
Auto-HSCT remains a cornerstone of management of multiple myeloma in developing countries.
Abstract
Multiple myeloma (MM) is a plasma cell malignancy with significant global disparities in outcomes owing to variable access to effective therapies. This study evaluates the clinical outcomes of newly diagnosed MM (NDMM) patients undergoing autologous hematopoietic stem cell transplantation (auto-HSCT) at King Hussein Cancer Center (KHCC) in Jordan. We included all adult NDMM patients who underwent auto-HSCT after first-line induction at KHCC between 2009 and 2023. Data on frontline regimens, pre- and post-HSCT responses, and survival outcomes were collected. Responses were assessed using the International Myeloma Working Group criteria. Kaplan-Meier estimates were used for overall survival (OS) and progression-free survival (PFS), with log-rank tests for comparisons. A total of 221 patients were identified. The median age at diagnosis was 54 years (range: 32 - 67 years). The most common frontline regimen was bortezomib, thalidomide, and dexamethasone (42%), while only 2% received lenalidomide. The overall response rate to frontline therapy was 95%, with 2% achieving stringent complete response (sCR), 13% complete response (CR), and 50% very good partial response (VGPR). Post-auto-HSCT, the sCR and CR rates increased to 13% and 35%, respectively. With a median follow-up of 48 months (range: 6-201 months), the median PFS was 41.1 months (95% CI, 37.9–47.2 months), and the median OS was 92 months (95% CI, 72–119 months). In conclusion, Auto-HSCT significantly deepens responses in patients with NDMM, particularly in resource-limited settings. However, limited access to maintenance therapies and novel treatments underscores the need for broader therapeutic options to optimize MM care in such settings.
Author notes
Authors contributed equally to the manuscript
Some of the information contained in this study were presented in an abstract format at the 66th American Society of Hematology Annual Meeting & Exposition in San Diego, CA, Abstract #2277.
Data Sharing Statement:
The data supporting this study’s findings are available upon reasonable request.. Access to data will be granted in line with institutional policies and with approval from the King Hussein Cancer Center Institutional Review Board.
Conflict of interest statement: No funding was provided for this study. SAH reports receiving consulting fees from Jansen, Sanofi, Pfizer and Galapagos and research funding from International Myeloma Society, Jansen, and Alexion. Other authors declare no conflicts of interest.
