-Author name in bold denotes the presenting author
-Asterisk * with author name denotes a Non-ASH member
Clinically Relevant Abstract denotes an abstract that is clinically relevant.

PhD Trainee denotes that this is a recommended PHD Trainee Session.

Ticketed Session denotes that this is a ticketed session.

3355 Real-World Outcomes of Newly Diagnosed Multiple Myeloma (NDMM) Patients Treated before the Anti-CD38 Antibodies Era in France, the Emmy Cohort 2017 to 2020

Program: Oral and Poster Abstracts
Session: 652. Multiple Myeloma: Clinical and Epidemiological: Poster II
Hematology Disease Topics & Pathways:
Research, epidemiology, Clinical Research, real-world evidence
Sunday, December 10, 2023, 6:00 PM-8:00 PM

Laure Vincent, MD1*, Olivier Decaux, MD, PhD2*, Aurore Perrot, MD, PhD3, Bruno Royer, MD4*, Thomas Chalopin, MD5*, Arthur Bobin6*, Margaret Macro, MD7*, Denis Caillot, MD8*, Lionel Karlin9*, Caroline Jacquet, MD10*, Cécile Sonntag, MD11*, Mohamad Mohty, MD, PhD12, Laurent Frenzel, MD, PhD13*, Arnaud Jaccard14,15*, Laurence Sanhes16*, Driss Chaoui17*, Nathalie Texier18*, Chanaz Louni19*, Zakaria Maarouf20*, Herve Avet Loiseau, MD, PhD21, Cyrille Hulin, MD22,23* and Karim Belhadj Merzoug, MD24*

1Department of Clinical Hematology, Montpellier University Hospital Center, Montpellier, France
2Centre Hospitalier Universitaire de Rennes - Hopital Pontchaillou, Rennes, France
3CHU de Toulouse, IUCT-O, Université de Toulouse, UPS, Service d’Hématologie, Toulouse, France
4Saint Louis Hospital, Paris, France
5Centre hospitalier universitaire de Tours, Hospital, Tours, FRA
6CHU Poitiers, Poitiers, France
7Hopital Cote De Nacre, Caen, France
8University Hospital INSERM UMR1231 and SAPHIIR-UMR 1231, University of Burgundy & France Comte, Dijon, France
9Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
10CHU de Nancy, Vandoeuvre Les Nancy, FRA
11University Hospital, Hôpital Hautepierre, Strasbourg, France
12Department of Haematology, Saint Antoine Hospital, Paris, France
13Department of Haematology, Institut Necker, Paris, FRA
14Referral Center for AL Amyloidosis, Limoges, France
15Hematologie clinique, CHU de Limoges, HoPital Dupuytren, Limoges Cedex 1, FRA
16Centre Hospitalier Perpignan, Perpignan, FRA
17hôpital Victor Dupouy 33134232447, Argenteuil, FRA
18Kappa Santé, PARIS, FRA
19IFM, Paris, France
20IFM, Paris, IDF, France
21Iuct-Oncopole Toulouse, Toulouse, FRA
22Centre Hospitalier Universitaire Bordeaux, Bordeaux, France
23Centre Hospitalier Universitaire de Bordeaux, Pessac Cedex, FRA
24Unité Hémopathies Lymphoïdes, Centre Hospitalier Universitaire Henri Mondor, Créteil, France


In randomized clinical trials (RCTs), patients (pts) with comorbidities or a very aggressive presentation of myeloma may be excluded. The results of RCTs may not be generalizable to pts in the real-world setting. Therefore, RCT data need to be backed up by results from real-world studies.


EMMY is a non-interventional, prospective study conducted in 73 IFM (Intergroupe Francophone du Myélome) sponsor sites in France. Any patient initiating treatment for multiple myeloma (MM) over a 3-month (mo) period, from October to December, is included, since 2017. It is a dynamic cohort with 900 pts on average, enrolled each year. Here, we present the results of NDMM pts for the first 4 years of inclusion (2017 to 2020). Pts with NDMM who receive front-line therapy with an autologous stem cell transplant (ASCT group) are described separately from non-transplant eligible pts (NTE group).


1597 pts with NDMM were included in EMMY over the 2017–2020 period. Of these, 1036 were in the NTE group (64.9%) and 561 in the ASCT group (35.1%). Data are presented with a median follow-up of 23.7 mo (IQR 12.3 - 39.0).

  • ASCT group

These pts had a median age of 60.6 years (range 23.4 – 78.5). 5.2 % were older than 70 years at ASCT.

In routine practice, cytogenetic tests were carried out for 75.7% of pts, 19.6% of them harboured high-risk (HR) anomalies of t(4;14) or del(17p).

The period 2017–2020 was marked by a shift in induction treatment from Velcade Thalidomide dexamethasone (VTd) (n = 163, 29.1% of pts who received ASCT) to Velcade Revlimid dexamethasone (VRd) (n = 309, 55.1%).

Fifty-three (9.5%) pts received a double transplantation which was stable over time. 22.8 % of pts with HR anomalies received a double transplant.

  • NTE group

The 1036 NTE pts had a median age of 74.9 years (range 33.8 – 97.8), and more than 30.4% (n = 315) were aged ≥ 80 years. Among these pts, 65.9% were considered frail, with 33.6% having an Eastern Cooperative Oncology Group-Performance Status (ECOG-PS) ≥ 2 and almost half (47.1%) had comorbidities. Significant renal impairment (glomerular filtration rate [GFR] < 30 mL/min) was observed in 118 (13%) pts at treatment initiation.

A subgroup of 126 younger pts (age < 65 years) was considered ineligible for transplantation.

Regarding cytogenetics 56.4% of the pts were tested in regular practice (mean age 73.3 years).

NTE pts mostly received three main combinations: VRd (28.4% of pts, n = 294), Velcade Melphalan prednisone (VMp) (21.9% of pts, n = 21.9%) and Revlimid dexamethansone (Rd) (21.1%, n = 219). During the study period, VMp use decreased from 36.9% to 6.5% of pts, VRd use increased from 10.6% to 48.5% and Rd use remained constant, at around 20%. Other bortezomib-based regimens, including Velcade dexamethasone (Vd) and Velcade Cyclophosphamide dexamethasone (VCd), were used steadily, in approximately 12% and 7% of pts, respectively, over the period.

  • Survival data

Median progression-free survival (mPFS) was 25.8 mo (95% CI: 23.5–29.1) in the overall NDMM population, 46.5 mo (95% CI: 37.8–50.6) in pts who received ASCT and 18.7 mo (95% CI: 16.3–20.8) in NTE pts (P < 0.0001). (Figure 1).

The median PFS2 (mPFS2) was estimated at 50.6 mo (95% CI: 47.6–NA) in all pts with NDMM. mPFS2 was 36.4 mo (95% CI: 34.7–39.9) in NTE pts; it was not reached in the ASCT group.

The median overall survival (OS) had not yet been reached. The estimated OS rate was 72.9% (95% CI: 69.8–75.9) at 48 mo for the total NDMM population. (Figure 2).

  • AE leading to discontinuation.

139 pts experienced an adverse event (AE) leading to treatment discontinuation (6.8 % of ASCT pts and 14.5% in the NTE group). This occurred at a median of 4.3 mo after treatment initiation and was mainly reported with the most used agents (lenalidomide, bortezomib or melphalan). The most frequently reported AEs were neuropathy (n = 14; 10.1%), digestive disorders (n = 13; 9.4%), rash (n = 12; 8.6%), deterioration of general condition (n = 12; 8.6%), cardiovascular AEs (n = 10; 7.2%) and acute renal failure (n = 10; 7.2%).


The 2017-2020 period for pts with NDMM in France was marked by the expansion of the use of lenalidomide in first line for the majority of pts. A major difference in PFS and OS is still observed between ASCT and NTE pts. A shorter PFS than in IFM2009 trial (PFS 50 mo) was observed in EMMY ASCT pts.

Disclosures: Vincent: BMS, Takeda: Membership on an entity's Board of Directors or advisory committees, Other: Financing meeting participation; Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Financing meeting participation; Pfizer: Other: Financing meeting participation. Decaux: Janssen, BMS, GSK, Sanofi, Takeda, Roche, Gilead: Honoraria. Perrot: Abbvie, Adaptive, Amgen, BMS, Janssen, Pfizer, Sanofi, Takeda: Honoraria. Macro: Janssen, Takeda: Honoraria, Other: Travel/accommodation, Research Funding; GSK, Sanofi: Honoraria. Karlin: AbbVie, Amgen, Celgene, Janssen, Sanofi, Takeda: Honoraria; Amgen, Celgene, GSK, Janssen, Takeda: Consultancy. Sonntag: Janssen, Takeda, BMS and Sanofi: Membership on an entity's Board of Directors or advisory committees. Mohty: JAZZ PHARMACEUTICALS: Honoraria, Research Funding. Frenzel: Pfizer: Consultancy, Other: Grant, Research Funding; CSL Berhing: Consultancy, Research Funding; Biomarin: Consultancy; Roche: Consultancy. Hulin: Amgen: Honoraria; Sanofi: Honoraria; AbbVie: Honoraria; Pfizer: Honoraria; Janssen: Honoraria; Bristol Myers Squibb: Honoraria. Belhadj Merzoug: BMS: Research Funding; Amgen, BMS, Janssen, Sanofi: Honoraria; Amgen, Janssen, Pfizer, Sanofi, Takeda: Other: Travel Support.

*signifies non-member of ASH