Real-world treatment and long-term outcomes after autologous stem cell transplantation in first line for myeloma in France and Algeria before the daratumumab era

INTRODUCTION: Despite numerous therapeutic advances, first line standard care for eligible multiple myeloma (MM) patients still include high-dose melphalan and autologous stem cell transplantation (ASCT). METHODS: Our study concerned MM patients who received ASCT followed or not by consolidation and maintenance, treated in two reference centers in France (Lyon n=342) and in Algeria (Oran n=452) before the daratumumab era. RESULTS: Despite differences in resources, we showed similar long-term Overall Survival (OS) for the two groups and similar survival for patients who did not receive any chemotherapy after ASCT for relapse. After using the instant ratio, we found a longer Time to Next Treatment for Algerian patients compared to French patients. Regarding patients who relapsed after ASCT we found a significantly better OS for French patients who received up to 3 lines of treatment after ASCT compared to Algerian patients CONCLUSION: The study of long-term overall survival of MM patients after ASCT remains very useful particularly for countries for which innovative therapies including immunotherapy are not accessible, and the differences observed during ASCT management and after relapse could point to paths for improving certain clinical situations regarding the offer of MM care in these countries.