Improved response with post- ASCT consolidation by low dose thalidomide, cyclophosphamide and dexamethasone as first line treatment for multiple myeloma.

Autor: Rabin, Neil, Percy, Laura, Khan, Iftekhar, Quinn, John, D'Sa, Shirley, Yong, Kwee L.
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Zdroj: British Journal of Haematology; Aug2012, Vol. 158 Issue 4, p499-505, 7p, 2 Charts, 2 Graphs
Abstrakt: The use of consolidation or maintenance to improve disease response, and hence clinical outcome, following autologous stem cell transplantation ( ASCT) remains the subject of intense clinical research. We carried out a single-arm study to assess the toxicity and efficacy of a short block of consolidation therapy with cyclophosphamide, low dose thalidomide and dexamethasone ( CTD) in patients within 6 months following ASCT, as part of frontline therapy for symptomatic multiple myeloma. Forty-five patients who had not progressed were enrolled on the study, and 43 completed treatment on protocol. This regimen was well tolerated soon after ASCT, with only grade 1/2 toxicity apart from neutropenia, and no long-term sequelae. Importantly, CTD consolidation improved the depth of response in treated patients, increasing the complete/very good partial response rate from 44% at 3 months, to 72% at 12 months, which was significantly higher compared with a historical group of control patients ( P = 0·002). There was a trend to longer progression-free survival that favoured the study group. Consolidation therapy did not adversely affect subsequent disease response to salvage therapies at relapse. We conclude that CTD consolidation may be a useful, non-toxic and cost-effective strategy to deepen disease response following ASCT, and deserves further study in a randomized trial. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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