BACKGROUND: Complete response has been considered a surrogate for favorable long-term outcome in multiple myeloma. Data on the impact of the duration of response on prognosis are lacking. PATIENTS AND METHODS: Of the 899 patients enrolled in Total Therapy trials (Total Therapy 1, N = 231; Total Therapy 2, N = 668), 254 survived for > 5 years. The prognostic impact of continuous (Rc) versus discontinuous (Rd) 4-year remission after 5-year survival was examined along with laboratory features present at baseline and at 5 years. RESULTS: Most baseline prognostic features were evenly distributed among Rc and Rd groups; however, a greater proportion of Rc patients were enrolled in Total Therapy 2 (60%) compared with Rd (19%; P < 0.001). Twelve-year survival (7 years after the 5-year landmark) was 66% with Rc and only 30% with Rd. Hypodiploidy and deletion 13, present in 24 patients at baseline, were associated with a 12-year survival of only 20%. Among the 200 patients lacking these cytogenetic abnormalities, Rc (n = 141) defined a superior 12-year survival rate of 70% versus 35% among those with Rd (n = 59). Initial quality of response (complete response) or having received the scheduled tandem transplantations did not affect post-5-year survival. CONCLUSION: Five-year Rc appears to be an important prerequisite for prolonged subsequent overall survival.
BACKGROUND: Complete response has been considered a surrogate for favorable long-term outcome in multiple myeloma. Data on the impact of the duration of response on prognosis are lacking. PATIENTS AND METHODS: Of the 899 patients enrolled in Total Therapy trials (Total Therapy 1, N = 231; Total Therapy 2, N = 668), 254 survived for > 5 years. The prognostic impact of continuous (Rc) versus discontinuous (Rd) 4-year remission after 5-year survival was examined along with laboratory features present at baseline and at 5 years. RESULTS: Most baseline prognostic features were evenly distributed among Rc and Rd groups; however, a greater proportion of Rc patients were enrolled in Total Therapy 2 (60%) compared with Rd (19%; P < 0.001). Twelve-year survival (7 years after the 5-year landmark) was 66% with Rc and only 30% with Rd. Hypodiploidy and deletion 13, present in 24 patients at baseline, were associated with a 12-year survival of only 20%. Among the 200 patients lacking these cytogenetic abnormalities, Rc (n = 141) defined a superior 12-year survival rate of 70% versus 35% among those with Rd (n = 59). Initial quality of response (complete response) or having received the scheduled tandem transplantations did not affect post-5-year survival. CONCLUSION: Five-year Rc appears to be an important prerequisite for prolonged subsequent overall survival.
Authors: Sarah K Johnson; Christoph J Heuck; Anthony P Albino; Pingping Qu; Qing Zhang; Bart Barlogie; John D Shaughnessy Journal: Int J Hematol Date: 2011-10-15 Impact factor: 2.490
Authors: Victoria Bedell; Stephen J Forman; Karl Gaal; Vinod Pullarkat; Lawrence M Weiss; Marilyn L Slovak Journal: J Mol Diagn Date: 2007-11 Impact factor: 5.568
Authors: David Avigan; Parameswaran Hari; Minoo Battiwalla; Michael R Bishop; Sergio A Giralt; Nancy M Hardy; Nicolaus Kröger; Alan S Wayne; Katharine C Hsu Journal: Biol Blood Marrow Transplant Date: 2013-09-07 Impact factor: 5.742
Authors: Dan Jia; Nathan A Koonce; Roopa Halakatti; Xin Li; Shmuel Yaccoby; Frances L Swain; Larry J Suva; Leah Hennings; Marc S Berridge; Scott M Apana; Kevin Mayo; Peter M Corry; Robert J Griffin Journal: Radiat Res Date: 2010-06 Impact factor: 2.841