Superiority of thalidomide and dexamethasone over vincristine-doxorubicindexamethasone (VAD) as primary therapy in preparation for autologous transplantation for multiple myeloma
| Autor: | CAVO, MICHELE, ZAMAGNI, ELENA, TOSI, PATRIZIA, TACCHETTI, PAOLA, CELLINI, CLAUDIA, CANGINI D, DE VIVO, ANTONIO, TESTONI, NICOLETTA, NICCI, CHIARA, TERRAGNA, CAROLINA, GRAFONE T, PERRONE, GIULIA, CECCOLINI, MICHELA, TURA, SANTE, BACCARANI, MICHELE, BOLOGNA STUDY |
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| Přispěvatelé: | CAVO M, ZAMAGNI E, TOSI P, TACCHETTI P, CELLINI C, CANGINI D, DE VIVO A, TESTONI N, NICCI C, TERRAGNA C, GRAFONE T, PERRONE G, CECCOLINI M, TURA S, BACCARANI M., BOLOGNA STUDY. |
| Rok vydání: | 2005 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Immunology VAD Regimen Anti-Inflammatory Agents Hematopoietic stem cell transplantation Biochemistry Gastroenterology Dexamethasone MULTIPLE MYELOMA Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Autologous transplantation Multiple myeloma Retrospective Studies Chemotherapy business.industry Hematopoietic Stem Cell Transplantation Cell Biology Hematology Middle Aged medicine.disease Thalidomide Surgery Transplantation Doxorubicin Vincristine Case-Control Studies business Immunosuppressive Agents medicine.drug |
| Zdroj: | Blood. 106:35-39 |
| ISSN: | 1528-0020 0006-4971 |
| Popis: | The aim of the present study was to compare thalidomide-dexamethasone (Thal-Dex) and vincristine-doxorubicin-dexamethasone (VAD) as primary therapy in preparation for autologous peripheral blood stem-cell (PBSC) transplantation for multiple myeloma (MM). For this purpose, we performed a retrospective matched case-control analysis of 200 patients who entered 2 consecutive studies from 1996 to 2004 and received Thal-Dex (n = 100) or VAD (n = 100) administered for 4 months before collection of PBSCs and autologous transplantation. Matching criteria included age, clinical stage, and serum β2-microglobulin levels. In comparison with VAD, Thal-Dex resulted in a significantly higher response rate (52% versus 76%, respectively; P < .001) and effected more profound reduction in myeloma cell mass of both immunoglobulin G (IgG; P = .02) and IgA (P = .03) type. More frequent toxicities included nonfatal deep vein thrombosis with Thal-Dex (15%) and granulocytopenia with VAD (12%). In each of the 2 treatment groups, 91% of patients proceeded to PBSC mobilization. The median number of collected CD34+ cells was 7.85 × 106/kg in the Thal-Dex group and 10.5 × 106/kg in the control group. Thal-Dex may be considered an effective and relatively well-tolerated oral alternative to the more complex VAD regimen as front-line therapy for MM patients who are candidates for subsequent autologous transplantation. |
| Databáze: | OpenAIRE |
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