High-dose chemoradiotherapy and autologous blood stem cell transplantation in multiple myeloma: results of a phase II trial involving 63 patients
| Autor: | François Dreyfus, Jean-Claude Brouet, Jean-Paul Fermand, Philippe Ravaud, Xavier Mariette, Marine Divine, Sylvie Chevret, Véronique Leblond |
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| Předmět: |
Adult
Male medicine.medical_specialty Time Factors medicine.medical_treatment Immunology Gastroenterology Transplantation Autologous Biochemistry Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Cyclophosphamide Multiple myeloma Chemotherapy business.industry Hematopoietic Stem Cell Transplantation Cell Biology Hematology Total body irradiation Middle Aged medicine.disease Prognosis Minimal residual disease Combined Modality Therapy Survival Analysis Surgery Radiation therapy Transplantation Radiography Survival Rate Doxorubicin Vincristine Female Steroids Stem cell business Multiple Myeloma beta 2-Microglobulin Chemoradiotherapy Follow-Up Studies |
| Zdroj: | Europe PubMed Central Scopus-Elsevier |
| Popis: | Sixty-three patients with high tumor mass multiple myeloma were treated with high-dose chemotherapy and total body irradiation supported by autologous blood stem cell transplantation. After high-dose therapy, they were monitored for a median of 44 months. Seven patients died early from toxicity. All the other patients, including those whose disease was resistant to previous therapies, showed a tumor mass reduction. At 6 months postengraftment, 40 (71%) of the surviving patients had minimal residual disease and 11 (20%) were in apparent complete remission. During follow-up, 25 out of the 63 (39%) patients relapsed and 16 of these died; 31 (49%) had a sustained remission. The median overall and event-free survival times after transplantation were 59 and 43 months, respectively. The initial serum beta 2-microglobulin value (> or < 2.8 mg/L) and length of previous therapy (> or < 6 courses of chemotherapy) were the only significant prognostic factors. In all surviving patients, blood stem cell autograft provided satisfactory and sustained haematopoietic reconstitution most often within 15 days. High dose chemoradiotherapy followed by autologous blood stem cell transplantation is thus an important therapeutic option for young patients with aggressive multiple myeloma. |
| Databáze: | OpenAIRE |
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