OBJECTIVE: Induction high-dose chemotherapy followed by myeloablative melphalan (HD-Mel) treatment and autologous hematopoietic stem-cell support (autoSCT) is a standard treatment for multiple myeloma (MM) either upfront or in relapse after conventional treatment. We performed a retrospective analysis of consecutive patients undergoing a late repeat HD-Mel/autoSCT treatment for MM. METHODS: Data from 24 consecutive patients with MM who underwent a myeloablative treatment with HD-Mel late after completion of upfront first high-dose therapy were assessed for toxicity, response, progression-free survival (PFS) and time to next treatment (TTNT). These data were correlated with the results obtained after the initial high dose therapy and autoSCT. RESULTS: A total of 23 patients were treated with novel drugs (lenalidomide, thalidomide, bortezomib) after relapse to initial autoSCT. The median overall survival (OS) of all patients was 90 months. 19 patients (79%) achieved a very good partial remission (VGPR) or complete remission (CR) after initial autoSCT, compared with 42% after late autoSCT. PFS and TTNT were 19 and 24 months after initial compared with 13 and 21 months after late autoSCT. Univariate analysis identified initial response duration and the achievement of a CR/VGPR after the initial transplantation to be associated with prolonged response after repeat autoSCT. CONCLUSIONS: Our data indicate that late high-dose treatment followed by autoSCT is safe and effective after upfront intensive treatment, can bridge to allogeneic SCT, and encourage collection of an additional graft.
OBJECTIVE: Induction high-dose chemotherapy followed by myeloablative melphalan (HD-Mel) treatment and autologous hematopoietic stem-cell support (autoSCT) is a standard treatment for multiple myeloma (MM) either upfront or in relapse after conventional treatment. We performed a retrospective analysis of consecutive patients undergoing a late repeat HD-Mel/autoSCT treatment for MM. METHODS: Data from 24 consecutive patients with MM who underwent a myeloablative treatment with HD-Mel late after completion of upfront first high-dose therapy were assessed for toxicity, response, progression-free survival (PFS) and time to next treatment (TTNT). These data were correlated with the results obtained after the initial high dose therapy and autoSCT. RESULTS: A total of 23 patients were treated with novel drugs (lenalidomide, thalidomide, bortezomib) after relapse to initial autoSCT. The median overall survival (OS) of all patients was 90 months. 19 patients (79%) achieved a very good partial remission (VGPR) or complete remission (CR) after initial autoSCT, compared with 42% after late autoSCT. PFS and TTNT were 19 and 24 months after initial compared with 13 and 21 months after late autoSCT. Univariate analysis identified initial response duration and the achievement of a CR/VGPR after the initial transplantation to be associated with prolonged response after repeat autoSCT. CONCLUSIONS: Our data indicate that late high-dose treatment followed by autoSCT is safe and effective after upfront intensive treatment, can bridge to allogeneic SCT, and encourage collection of an additional graft.
Authors: Robert Z Orlowski; Arnon Nagler; Pieter Sonneveld; Joan Bladé; Roman Hajek; Andrew Spencer; Jesús San Miguel; Tadeusz Robak; Anna Dmoszynska; Noemi Horvath; Ivan Spicka; Heather J Sutherland; Alexander N Suvorov; Sen H Zhuang; Trilok Parekh; Liang Xiu; Zhilong Yuan; Wayne Rackoff; Jean-Luc Harousseau Journal: J Clin Oncol Date: 2007-08-06 Impact factor: 44.544
Authors: Francesca Elice; Roberto Raimondi; Alberto Tosetto; Anna D'Emilio; Eros Di Bona; Andrea Piccin; Francesco Rodeghiero Journal: Am J Hematol Date: 2006-06 Impact factor: 10.047
Authors: J Anthony Child; Gareth J Morgan; Faith E Davies; Roger G Owen; Susan E Bell; Kim Hawkins; Julia Brown; Mark T Drayson; Peter J Selby Journal: N Engl J Med Date: 2003-05-08 Impact factor: 91.245
Authors: S Kumar; S T Mahmood; M Q Lacy; A Dispenzieri; S R Hayman; F K Buadi; D Dingli; S V Rajkumar; M R Litzow; M A Gertz Journal: Bone Marrow Transplant Date: 2008-06-30 Impact factor: 5.483
Authors: Martin Kropff; Guido Bisping; Elke Schuck; Peter Liebisch; Nicola Lang; Markus Hentrich; Tobias Dechow; Nicolaus Kröger; Hans Salwender; Bernd Metzner; Orhan Sezer; Monika Engelhardt; Hans-Heinrich Wolf; Hermann Einsele; Sarah Volpert; Achim Heinecke; Wolfgang E Berdel; Joachim Kienast Journal: Br J Haematol Date: 2007-08 Impact factor: 6.998