Treatment outcome and prognostic factor analysis in transplant-eligible Chinese myeloma patients receiving bortezomib-based induction regimens including the staged approach, PAD or VTD

Autor: Ching Wa Lau, Raymond Liang, Thomas S.K. Wan, Chor Sang Chim, Albert K. W. Lie, Edmond S. K. Ma, Eric Y. T. Chan, Eric Tse, Yok-Lam Kwong, Joycelyn Sim, Herman Sung Yu Liu, Sze Fai Yip
Rok vydání: 2012
Předmět:
Male
Oncology
Cancer Research
medicine.medical_treatment
Myeloma
Hematopoietic stem cell transplantation
Dexamethasone
Bortezomib
Autologous stem-cell transplantation
Deep vein thrombosis
Antineoplastic Combined Chemotherapy Protocols
Staged approach
Multiple myeloma
Remission Induction
Hematopoietic Stem Cell Transplantation
lcsh:Diseases of the blood and blood-forming organs
Hematology
Middle Aged
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Boronic Acids
Thalidomide
Survival Rate
Treatment Outcome
Vincristine
Pyrazines
Female
VTD
Multiple Myeloma
medicine.drug
Adult
medicine.medical_specialty
Prognostic factors
lcsh:RC254-282
Internal medicine
medicine
Humans
Molecular Biology
Survival rate
Aged
Neoplasm Staging
lcsh:RC633-647.5
business.industry
Research
International Agencies
medicine.disease
PAD
Surgery
Doxorubicin
business
Zdroj: Journal of Hematology & Oncology
Journal of Hematology & Oncology, Vol 5, Iss 1, p 28 (2012)
ISSN: 1756-8722
DOI: 10.1186/1756-8722-5-28
Popis: Background We have reported promising outcomes using a staged approach, in which bortezomib/thalidomide/dexamethasone was used only in 14 patients with suboptimal response to VAD (vincristine/adriamycin/dexamethasone) before autologous stem cell transplantation (ASCT). Here we compared the outcomes of the staged approach with frontline PAD (bortezomib/doxorubicin/dexamethasone) or VTD (bortezomib/thalidomide/dexamethasone) induction, and analysed prognostic factors for outcome. Patients and methods Ninety-one transplant-eligible Chinese patients received three induction regimens prior to ASCT [staged approach (N = 25), PAD (N = 31), VTD (N = 35)]. and received thalidomide maintenance for 2 years post-ASCT. Results 43 (47.3%) patients had International Staging System (ISS) III disease. By an intention-to-treat analysis, the overall CR/nCR rate were 37.4% post-induction, and 62.6% post-ASCT. Five-year overall (OS) and event-free (EFS) survivals were 66% and 45.1%. There was no difference of the post-induction CR/nCR rate, EFS or OS between patients induced by these three regimens. Moreover, ISS III disease did not affect CR/nCR rates. Multivariate analysis showed that ISS and post-ASCT CR/nCR impacted OS while ISS and post-induction CR/nCR impacted EFS. Conclusions These three induction regimens produced comparable and favorable outcomes in myeloma. The unfavorable outcome of ISS stage III persisted despite upfront/early use of bortezomib. CR/nCR predicted favorable survivals.
Databáze: OpenAIRE
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