Straka, Christian and Liebisch, Peter and Salwender, Hans and Hennemann, Burkhard and Metzner, Bernd and Knop, Stefan and Adler-Reichel, Sigrid and Gerecke, Christian and Wandt, Hannes and Bentz, Martin and Bruemmendorf, Tim Hendrik and Hentrich, Marcus and Pfreundschuh, Michael and Wolf, Hans-Heinrich and Sezer, Orhan and Bargou, Ralf and Jung, Wolfram and Truemper, Lorenz and Hertenstein, Bernd and Heidemann, Else and Bernhard, Helga and Lang, Nicola and Frickhofen, Norbert and Hebart, Holger and Schmidmaier, Ralf and Sandermann, Andreas and Dechow, Tobias and Reichle, Albrecht and Schnabel, Brigitte and Schaefer-Eckart, Kerstin and Langer, Christian and Gramatzki, Martin and Hinke, Axel and Emmerich, Bertold and Einsele, Hermann (2016) Autotransplant with and without induction chemotherapy in older multiple myeloma patients: long-term outcome of a randomized trial. HAEMATOLOGICA, 101 (11). pp. 1398-1406. ISSN 0390-6078,
Full text not available from this repository. (Request a copy)Abstract
Autologous transplantation is controversial for older patients with multiple myeloma. The role of age-adjusted high-dose melphalan and the impact of induction chemotherapy cycles is still unclear. A total of 434 patients aged 60-70 years were randomly assigned to 4 cycles of standard anthracycline-based induction chemotherapy or no induction. For all patients, double autologous transplantation after melphalan 140 mg/m(2) (MEL140) was planned. The primary end point was progression-free survival. Of 420 eligible patients, 85% received a first transplant and 69% completed double transplantation. Treatment duration was short with a median of 7.7 months with induction chemotherapy cycles and 4.6 months without induction. On an intention-to-treat basis, median progression-free survival with induction chemotherapy cycles (207 patients) was 21.4 months versus 20.0 months with no induction cycles (213 patients) (hazard ratio 1.04, 95% confidence interval 0.84-1.28; P= 0.36). Per protocol, progression-free survival was 23.7 months versus 23.0 months (P= 0.28). Patients aged 65 years or over (55%) did not have an inferior outcome. Patients with low-risk cytogenetics [absence of del17p13, t(4; 14) and 1q21 gains] showed a favorable overall survival and included the patients with sustained first remission. MEL140 was associated with a low rate of severe mucositis (10%) and treatment-related deaths (1%). Based on hazard ratio, the short treatment arm consisting of mobilization chemotherapy and tandem MEL140 achieved 96% of the progression-free survival, demonstrating its value as an independent component of therapy in older patients with multiple myeloma who are considered fit for autologous transplantation.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | STEM-CELL TRANSPLANTATION; THALIDOMIDE PLUS DEXAMETHASONE; ELDERLY-PATIENTS; AUTOLOGOUS TRANSPLANTATION; BORTEZOMIB INDUCTION; THERAPY; LENALIDOMIDE; MELPHALAN; MAINTENANCE; COMBINATION; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 12 Apr 2019 12:12 |
| Last Modified: | 12 Apr 2019 12:12 |
| URI: | https://pred.uni-regensburg.de/id/eprint/3980 |
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