An elective single autograft with high-dose melphalan: single-center study of 451 patients
| Autor: | Jennifer Treleaven, Claudius Rudin, R. L. Powles, Samar Kulkarni, Jayesh Mehta, Radovan Saso, Bhawna Sirohi, Clive Horton, Seema Singhal |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Adult
Male Melphalan medicine.medical_specialty Vincristine medicine.medical_treatment Single Center Transplantation Autologous chemistry.chemical_compound Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Leukapheresis Multiple myeloma Aged Probability Transplantation Hematology business.industry Remission Induction Hematopoietic Stem Cell Transplantation Middle Aged Prognosis medicine.disease Survival Analysis Hematopoietic Stem Cell Mobilization Nitrogen mustard Autotransplantation Surgery Treatment Outcome chemistry Female business medicine.drug |
| Zdroj: | Bone Marrow Transplantation. 36:19-24 |
| ISSN: | 1476-5365 0268-3369 |
| DOI: | 10.1038/sj.bmt.1705000 |
| Popis: | In all, 451 myeloma patients, 51% previously untreated, underwent elective single autotransplantation after 200 mg/m(2) melphalan between 1985 and 2001 at the Royal Marsden Hospital. The therapy sequence was: Induction (vincristine, doxorubicin, methylprednisolone+/-cyclophosphamide), marrow or filgrastim-mobilized blood stem cell harvest, autograft, and interferon-alpha2b maintenance. A total of 27 (6%) died of transplant-related toxicity, all within 3 months. Complete or near-complete remission was seen in 59% with an overall response rate of 91%. Subsequent disease progression was seen in 285, and 17 died of unrelated causes. In all, 206 patients were alive at the last follow-up, 6 months to 17.7 years post-transplant (median 65 months); 122 without disease progression at 6 months to 17.7 years (median 58 months). The median overall (OS) and event-free (EFS) survivals were 5.9 and 2.4 years, with 10-year OS and EFS probabilities of 31.4 and 16.5%, respectively. In Cox analysis, it was seen that significantly longer OS occurred for patients who had beta-2-microglobulin3.5 mg/l (P0.0001), age60 years (P=0.001) and albuminor =35 g/l (P=0.009). EFS was also longer if beta-2-microglobulin was3.5 mg/l (P=0.0056) and patients were60 years of age (P=0.033). We conclude that with a single planned autograft, patients with myeloma have an excellent outcome. |
| Databáze: | OpenAIRE |
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