| Autor: |
Giebel, Sebastian, Sobczyk-Kruszelnicka, Małgorzata, Blamek, Sławomir, Saduś-Wojciechowska, Maria, Najda, Jacek, Czerw, Tomasz, Mendrek, Włodzimierz, Woźniak, Grzegorz, Jochymek, Bożena, Radwan, Michał, Leszczyński, Wojciech, Dolla, Łukasz, D’Amico, Andrea, Ślosarek, Krzysztof, Hołowiecki, Jerzy, Miszczyk, Leszek |
| Zdroj: |
Bone Marrow Transplantation; June 2021, Vol. 56 Issue: 6 p1297-1304, 8p |
| Abstrakt: |
The goal of this phase II trial was to evaluate safety and efficacy of a tandem autologous hematopoietic cell transplantation (auto-HCT) using sequentially total marrow irradiation (TMI) at the dose of 12 Gy (4 Gy on days −3, −2, and −1) and melphalan 200 mg/m2for patients with multiple myeloma (MM). TMI was performed using helical tomotherapy. Additional “boosts” (total 24 Gy) were applied for patients with active lesions as revealed by PET-FDG. Fifty patients with median age 58 years (41–64 years) were included and received tandem auto-HCT. TMI resulted in absolute neutropenia in all patients. Grade 3 infections were reported in 30% patients. Other toxicities were rare. Proportion of patients who achieved at least very good partial response increased from 46% before the first auto-HCT to 82% after tandem transplantation. Complete remission rates changed from 10% to 42%, respectively. The probabilities of overall and progression-free survival at 5 years were 74% and 55%, respectively. No patient died without progression. We conclude that conditioning with TMI ± PET-guided “boosts” represents personalized treatment approach in MM and is characterized by very good toxicity profile. Tandem auto-HCT using TMI in sequence with high-dose melphalan appears safe with encouraging early efficacy. |
| Databáze: |
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