Literature DB >> 15249717

Second autologous transplantation for multiple myeloma patients relapsing after the first autograft -- a pilot study for the evaluation of experimental maintenance therapies. Report of the prospective non-randomized pilot study of the Czech Myeloma Group.

A Krivanová1, R Hájek, M Krejcí, V Scudla, K Indrák, J Bacovský, T Büchler, A Svobodník, Z Adam, J Mayer, J Vorlícek.   

Abstract

BACKGROUND: High-dose chemotherapy followed by autologous stem cell transplantation (AT) is accepted as first-line therapy for patients with multiple myeloma (MM), with very good tolerance and low mortality (2-3%). STUDY
DESIGN: We tested repeated transplantation with different experimental maintenance therapies in patients with MM relapsing/progressing after first AT. Results were compared using intra-individual analyses, therefore inter-individual differences are excluded (T2 model). PATIENTS AND METHODS: Between January 1997 and January 2003, 32 patients with relapsing/progressing MM after first AT were included in the pilot study, median follow-up was 75.2 months. They received the following experimental therapies: IL-2-activated PBSC (10 pts), pamidronate (4 pts), thalidomide (15 pts), consolidation chemotherapy CED (3 pts).
RESULTS: Sensitivity to C-VAD reinduction chemotherapy (4 cycles) was 50%, response to the second AT compared to the first was better in 7, the same in 16 and worse in 9 patients. Toxicity of the first and second transplantation was similar and usually did not exceed grade II (SWOG). Transplant-related mortality was 3% (1/32). Event-free survival after second AT (EFS II) is known in 22 patients; 7 have achieved prolongation of EFS II versus EFS I. In the whole group median EFS I was 15.7 months, median EFS II was 12.9 months, median overall survival (OS) was 79.1 months; 20/32 patients were alive at the time of analysis.
CONCLUSIONS: Repeated AT is a feasible and successful strategy in treatment of relapsing MM; response to second AT and toxicity were acceptable and similar to the first AT in our assessment. Copyright 2004 S. Karger GmbH, Freiburg

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Year:  2004        PMID: 15249717     DOI: 10.1159/000077977

Source DB:  PubMed          Journal:  Onkologie        ISSN: 0378-584X


  4 in total

Review 1.  Evidence-based mini-review: treatment options for patients with relapsed/refractory myeloma previously treated with novel agents and high-dose chemotherapy and autologous stem-cell transplantation.

Authors:  Nina Shah; Sagar Lonial
Journal:  Hematology Am Soc Hematol Educ Program       Date:  2010

2.  Soft-tissue extramedullary multiple myeloma prognosis is significantly worse in comparison to bone-related extramedullary relapse.

Authors:  Ludek Pour; Sabina Sevcikova; Henrieta Greslikova; Renata Kupska; Petra Majkova; Lenka Zahradova; Viera Sandecka; Zdenek Adam; Marta Krejci; Petr Kuglik; Roman Hajek
Journal:  Haematologica       Date:  2013-09-13       Impact factor: 9.941

3.  Salvage bortezomib-dexamethasone and high-dose melphalan (HDM) and autologous stem cell support (ASCT) in myeloma patients at first relapse after HDM with ASCT. A phase-2 trial.

Authors:  P Gimsing; Ø Hjertner; N Abildgaard; N F Andersen; T G Dahl; H Gregersen; T W Klausen; U-H Mellqvist; O Linder; R Lindås; N Tøffner Clausen; S Lenhoff
Journal:  Bone Marrow Transplant       Date:  2015-06-29       Impact factor: 5.483

4.  Multiple Extramedullary Plasmacytoma in a Setting of Complete Bone Marrow Remission: Food for Thought.

Authors:  Negi Preety; Kingsley Pamela Alice; Jomi Chinnu; Mathew Amrith; George Sneha; Immanuel Vivek; Abraham Puliyelil Abraham
Journal:  Int J Hematol Oncol Stem Cell Res       Date:  2017-10-01
  4 in total

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