A prospective PETHEMA study of tandem autologous transplantation versus autograft followed by reduced-intensity conditioning allogeneic transplantation in newly diagnosed multiple myeloma
| Autor: | Joan Bladé, Angel Leon, Javier García-Frade, Juan José Lahuerta, Dolores Carrera, Jesús F. San Miguel, Pascual Fernandez Abellan, Laura Rosiñol, Felipe de Arriba, Miguel T. Hernandez, Joaquín Díaz-Mediavilla, Belen Hernandez, José D. González, José A. Pérez-Simón, Juan Bergua, Anna Sureda, Javier de la Rubia |
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| Rok vydání: | 2008 |
| Předmět: |
medicine.medical_specialty
Transplantation Conditioning Allogeneic transplantation Immunology Graft vs Host Disease Kaplan-Meier Estimate Transplantation Autologous Biochemistry Gastroenterology Disease-Free Survival Autologous stem-cell transplantation Internal medicine Immunopathology Antineoplastic Combined Chemotherapy Protocols medicine Humans Transplantation Homologous Autologous transplantation Prospective Studies Multiple myeloma Hematology business.industry Cell Biology Middle Aged medicine.disease Surgery Clinical trial Transplantation Multiple Myeloma business Stem Cell Transplantation |
| Zdroj: | Blood. 112:3591-3593 |
| ISSN: | 1528-0020 0006-4971 |
| DOI: | 10.1182/blood-2008-02-141598 |
| Popis: | One hundred ten patients with multiple myeloma (MM) failing to achieve at least near-complete remission (nCR) after a first autologous stem cell transplantation (ASCT) were scheduled to receive a second ASCT (85 patients) or a reduced-intensity-conditioning allograft (allo-RIC; 25 patients), depending on the human leukocyte antigen (HLA)–identical sibling donor availability. There was a higher increase in complete remission (CR) rate (40% vs 11%, P = .001) and a trend toward a longer progression-free survival (PFS; median, 31 months vs not reached, P = .08) in favor of allo-RIC. In contrast, it was associated with a trend toward a higher transplantation-related mortality (16% vs 5%, P = .07), a 66% chance of chronic graft-versus-host disease and no statistical difference in event-free survival and overall survival. Although the PFS plateau observed with allo-RIC is very encouraging, this procedure is associated with high morbidity and mortality, and therefore it should still be considered investigational and restricted to well-designed prospective clinical trials. This trial is registered at ClinicalTrials.gov ID number NCT00560053 |
| Databáze: | OpenAIRE |
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