{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T17:12:29Z","timestamp":1763658749252,"version":"3.45.0"},"reference-count":43,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,7,4]],"date-time":"2024-07-04T00:00:00Z","timestamp":1720051200000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006436","name":"Celgene","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006436","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["HemaSphere"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Recommendations regarding the best time to start treatment in patients with relapsed\/refractory multiple myeloma (RRMM) after biological relapse\/progression (BR) are unclear. This observational, prospective, multicenter registry aimed to evaluate the impact on time to progression (TTP) of treatment initiation at BR versus at symptomatic clinical relapse (ClinR) based on the Spanish routine practice in adult patients with RRMM. Patients had two or less previous treatment lines and at least one previous partial response. Baseline characteristics and treatment outcomes were recorded, and survival was analyzed. Of 225 patients, 110 were treated at BR (TxBR group) and 115 at ClinR (TxClinR group) according to the investigators'\u00a0criteria. The proportion of patients with higher ECOG, previous noncomplete remission (CR), and second relapse were significantly higher in the TxBR group compared to the TxClinR group. TheTxClinR group showed improved outcomes, including TTP, compared to the TxBR group. Progression\u2010free survival increased in the TxClinR group (56.2 months) compared to the TxBR group (32.5 months) (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.0137), and median overall survival also increased (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.0897). Median TTP was significantly longer in patients relapsing from a CR (50.4 months) and in their first relapse (38.7 months) compared to those relapsing from a non\u2010CR response (32.9 months) and in their second relapse (25.2 months). Physicians seemed to start treatment earlier in RRMM patients with poor prognosis features. Previous responses to anti\u2010MM treatment and the number of prior treatment lines were identified as prognosis factors, whereby relapse from CR and first relapse were associated with a longer time to progression.\n                  <\/jats:p>","DOI":"10.1002\/hem3.81","type":"journal-article","created":{"date-parts":[[2024,7,4]],"date-time":"2024-07-04T23:38:38Z","timestamp":1720136318000},"source":"Crossref","is-referenced-by-count":0,"title":["Biological relapse in multiple myeloma: Outcome and treatment strategies in a Spanish real\u2010world setting"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2423-822X","authenticated-orcid":false,"given":"Adri\u00e1n","family":"Alegre","sequence":"first","affiliation":[{"name":"Hospital Universitario de la Princesa Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mercedes","family":"Gironella","sequence":"additional","affiliation":[{"name":"Hospital Universitari Vall d'Hebron Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando","family":"Escalante","sequence":"additional","affiliation":[{"name":"Hospital Universitario de Le\u00f3n, Le\u00f3n  Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan M.","family":"Bergua","sequence":"additional","affiliation":[{"name":"Hospital San Pedro de Alc\u00e1ntara C\u00e1ceres  Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"Mart\u00ednez\u2010Chamorro","sequence":"additional","affiliation":[{"name":"Hospital Universitario Quir\u00f3nsalud Madrid  Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aurelio","family":"L\u00f3pez","sequence":"additional","affiliation":[{"name":"Hospital Universitari Arnau de Vilanova Valencia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Hospital Universitario de Cabue\u00f1es Gij\u00f3n Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abelardo","family":"B\u00e1rez","sequence":"additional","affiliation":[{"name":"Hospital Nuestra Se\u00f1ora Sonsoles \u00c1vila Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nieves","family":"Somolinos","sequence":"additional","affiliation":[{"name":"Hospital Universitario de Getafe Getafe Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ernesto P.","family":"Persona","sequence":"additional","affiliation":[{"name":"Bioaraba [Onco\u2010Hematology Group], Vitoria\u2010Gasteiz, Osakidetza [OSI Araba], Hospital Universitario de \u00c1lava [Department of Hematology] Vitoria\u2010Gasteiz  Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexia S.","family":"Cabrera","sequence":"additional","affiliation":[{"name":"Hospital Universitario de Gran Canaria Doctor Negr\u00edn, Las Palmas de Gran Canaria  Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfons","family":"Soler","sequence":"additional","affiliation":[{"name":"Hospital Parc Taul\u00ed Sabadell Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bel\u00e9n I.","family":"Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico San Carlos Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joaqu\u00edn M.","family":"L\u00f3pez","sequence":"additional","affiliation":[{"name":"Hospital Universitario 12 de Octubre Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yolanda","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Hospital Universitario Josep Trueta Girona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ver\u00f3nica C.","family":"Gim\u00e9nez","sequence":"additional","affiliation":[{"name":"Hospital de Manises Valencia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonia","family":"Sampol","sequence":"additional","affiliation":[{"name":"Hospital Universitario Son Espases, Palma de Mallorca  Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina","family":"Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Hospital Universitario Infanta Leonor Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Vilanova","sequence":"additional","affiliation":[{"name":"Celgene S.L. 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