{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T21:49:58Z","timestamp":1784929798319,"version":"3.55.0"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100001422","name":"American Society of Hematology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001422","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    Functional high\u2010risk (FHR) multiple myeloma (FHRMM) is often defined as progression within 12\u201324\u2009months of front\u2010line autologous hematopoietic stem cell transplantation (AHSCT). For patients with early progression after suboptimal front\u2010line therapies, it is challenging to assign the disease progression to a true FHR phenotype versus less effective front\u2010line therapy. In this study, we combined data from three Center for International Blood and Marrow Transplant Research studies (MM18\u201002, MM19\u201001 and MM20\u201003). We included patients who received front\u2010line AHSCT between 2008 and 2018 and had progression &lt;12 (FHR12,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009465), &lt;18 (FHR18,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009672) or &lt;24\u2009months (FHR24,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009853) after AHSCT. We classified induction therapy as standard lenalidomide\u2010containing triplets (bortezomib, lenalidomide, dexamethasone [VRD]\/carfilzomib, lenalidomide, dexamethasone [KRD]) versus other (bortezomib, thalidomide, dexamethasone [VTD]\/bortezomib, cyclophosphamide, dexamethasone [VCD]\/bortezomib, dexamethasone [VD]\/lenalidomide, dexamethasone [RD]) and studied the impact of front\u2010line therapy on post\u2010FHR overall survival (OS). In the FHR12 cohort (follow\u2010up 48\u2009months), the OS after VRD\/KRD (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009238) was 21 versus 17\u2009months with other regimens (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009227, hazard ratio [HR]\u2009=\u20091.2, 95% confidence interval [CI]: 0.6\u20131.06). In a multivariable model, the HR for OS was 0.94 (95% CI: 0.7\u20131.3,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.69) for VRD\/KRD versus other regimens. There was no significant interaction between type of first\u2010line (1L) therapy and time from 1L AHSCT to first relapse in predicting OS. Similar results were seen for FHR18 and FHR24. FHRMM remains a negative prognostic factor irrespective of front\u2010line therapy and warrants consideration of T\u2010cell engagers' second\u2010line therapy.\n                  <\/jats:p>","DOI":"10.1111\/bjh.70490","type":"journal-article","created":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T10:03:16Z","timestamp":1776938596000},"page":"2134-2142","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Functional high\u2010risk phenotype predicts poor survival in multiple myeloma independent of front\u2010line treatment: A secondary analysis of\n                    <scp>CIBMTR<\/scp>\n                    data"],"prefix":"10.1111","volume":"208","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1663-0325","authenticated-orcid":false,"given":"Utkarsh","family":"Goel","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Cleveland Clinic  Cleveland Ohio USA"},{"name":"Department of Hematology and Medical Oncology, Taussig Cancer Center Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catalin","family":"Dragomirescu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Cleveland Clinic  Cleveland Ohio USA"},{"name":"Department of Hematology and Medical Oncology, Taussig Cancer Center Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saurabh","family":"Zanwar","sequence":"additional","affiliation":[{"name":"Division of Hematology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafaella Cassano","family":"Cassano","sequence":"additional","affiliation":[{"name":"Clinical Research Division Fred Hutchinson Cancer Center  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kara I.","family":"Cicero","sequence":"additional","affiliation":[{"name":"Clinical Research Division Fred Hutchinson Cancer Center  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1880-7094","authenticated-orcid":false,"given":"Andrew J.","family":"Cowan","sequence":"additional","affiliation":[{"name":"BC Cancer Agency  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Banerjee","sequence":"additional","affiliation":[{"name":"Clinical Research Division Fred Hutchinson Cancer Center  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6914-7439","authenticated-orcid":false,"given":"Faiz","family":"Anwer","sequence":"additional","affiliation":[{"name":"Department of Hematology and Medical Oncology, Taussig Cancer Center Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2473-6528","authenticated-orcid":false,"given":"Jack","family":"Khouri","sequence":"additional","affiliation":[{"name":"Department of Hematology and Medical Oncology, Taussig Cancer Center Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danai","family":"Dima","sequence":"additional","affiliation":[{"name":"Clinical Research Division Fred Hutchinson Cancer Center  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,23]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/hematology.2023000443"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2023.1240966"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2017.331"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2019.236588"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.16793"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375\u2010018\u20100057\u20105"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2016.147"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clml.2019.10.014"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2014.237"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2016.43"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2025.43.16_suppl.7501"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1200\/EDBK_433520"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.27422"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.70070"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2312054"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102025\u20101037"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtct.2021.10.022"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.34778"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.16987"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.04.242"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2025029987"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2025030113"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.21.01365"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467\u2010022\u201032145\u2010y"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102018\u201004\u2010842880"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2024.42.16_suppl.7504"}],"container-title":["British 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