{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T23:03:23Z","timestamp":1791932603861,"version":"4.3.4"},"reference-count":35,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T00:00:00Z","timestamp":1664409600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Elsa U. Pardee Foundation"},{"name":"International Myeloma Society"},{"name":"Paula and Rodger Riney Foundation Translational Research Award"},{"name":"Pelotonia Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Maintenance therapy after autologous stem cell transplant (ASCT) in multiple myeloma (MM) is the standard treatment and recommended to be continued until disease progression. However, in the real world, patients discontinue treatment due to various reasons. We sought to determine the effect of early versus late discontinuation on survival outcomes in MM patients who underwent ASCT at The Ohio State University. We retrospectively reviewed 340 patients who underwent ASCT from 2005 to 2016 and received maintenance therapy for at least six months without progression. We compared the outcomes of patients who received maintenance for three years or less (early group) to the patients who continued maintenance beyond three years (late group). Lenalidomide (89%) and bortezomib (10%) were the most common agents used for maintenance chemotherapy. In Kaplan\u2013Meier analysis, patients in the late group had prolonged progression-free (PFS) (p &lt; 0.001) and overall survival (OS) (p &lt; 0.001). The 5-year estimated OS in late group was 96% vs. 79% in the early group and 5-year PFS was 80% in late group vs. 50% in the early group. The most common reasons for discontinuation of maintenance in early group were adverse events (55.9%) and patient preference (22.5%). For the late group, it was disease progression (23.9%) and adverse events (14.3%). Fifty-five percent of patients in the late group were still on maintenance treatment at the last follow-up. Continuation of maintenance therapy was thus associated with improved outcomes, while adverse events prevented most patients from continuing treatment.<\/jats:p>","DOI":"10.3390\/jcm11195794","type":"journal-article","created":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T23:09:29Z","timestamp":1664492969000},"page":"5794","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Early versus Late Discontinuation of Maintenance Therapy in Multiple Myeloma"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2924-9825","authenticated-orcid":false,"given":"Jordan","family":"Nunnelee","sequence":"first","affiliation":[{"name":"College of Medicine, The Ohio State University, Columbus, OH 43210, USA"},{"name":"Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8676-7840","authenticated-orcid":false,"given":"Francesca","family":"Cottini","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology, The Ohio State University, Columbus, OH 43210, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiuhong","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology, The Ohio State University, Columbus, OH 43210, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Salman","family":"Faisal","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology, The Ohio State University, Columbus, OH 43210, USA"},{"name":"Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Elder","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology, The Ohio State University, Columbus, OH 43210, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Rosko","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology, The Ohio State University, Columbus, OH 43210, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naresh","family":"Bumma","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology, The Ohio State University, Columbus, OH 43210, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2166-2583","authenticated-orcid":false,"given":"Abdullah","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology, The Ohio State University, Columbus, OH 43210, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elvira","family":"Umyarova","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology, The Ohio State University, Columbus, OH 43210, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8838-1025","authenticated-orcid":false,"given":"Srinivas","family":"Devarakonda","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology, The Ohio State University, Columbus, OH 43210, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Don M.","family":"Benson","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology, The Ohio State University, Columbus, OH 43210, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne A.","family":"Efebera","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology, The Ohio State University, Columbus, OH 43210, USA"},{"name":"Bone Marrow Transplantation & Cellular Therapy, OhioHealth, Columbus, OH 43210, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1302-7099","authenticated-orcid":false,"given":"Nidhi","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology, The Ohio State University, Columbus, OH 43210, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1056\/NEJM199607113350204","article-title":"A Prospective, Randomized Trial of Autologous Bone Marrow Transplantation and Chemotherapy in Multiple Myeloma","volume":"335","author":"Attal","year":"1996","journal-title":"N. 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