Primary refractory multiple myeloma: a real-world experience with 85 cases

Artur Jurczyszyn, Anna Waszczuk-Gajda, Jorge J. Castillo, Katarzyna Krawczyk, Martin Stork, Ludek Pour, Lidia Usnarska-Zubkiewicz, Stanisław Potoczek, Iwona Hus, Julio Davila Valls, Parameswaran Hari, Saurabh Chhabra, Massimo Gentile, Gabor Mikala, Gergely Varga, Chor Sang Chim, Mark Fiala, Ravi Vij, Natalia Schutz, Marek RodzajAgnieszka Porowska, David H. Vesole, Agnieszka Druzd-Sitek, Jan Walewski, Ajay K. Nooka

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


This study determined whether 85 patients with multiple myeloma (MM) double-refractory to primary induction therapy with triplet regimens had a homogenous prognosis. The overall response rate (ORR) after the second-line therapy was 51%. Patients who proceeded to immediate autologous stem cell transplantation (ASCT) had better ORR than those who received conventional therapies (62% vs. 31%). The ORR for patients who had ASCT directly after the frontline therapy was higher than for those treated with other regimens as the second line therapy (91% vs. 45%) and offered ASCT as the third-line therapy (91% vs. 55%). The median progression-free survival (PFS) after the second-line therapy and median overall survival were 21.6 months and 35.6 months, respectively. ASCT after the second line treatment (HR = 0.24) was an independent predictor of PFS. Eligible patients with primary refractory MM achieve the most benefit from ASCT, also performed immediately after first line induction therapy.

Original languageEnglish
Pages (from-to)2868-2875
Number of pages8
JournalLeukemia and Lymphoma
Issue number12
StatePublished - Dec 2020


  • Double-refractory multiple myeloma
  • prognosis
  • survival
  • treatment response


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