Autologous Stem Cell Transplantation in Multiple Myeloma in the Era of Novel Drug Induction: A Retrospective Single-Center Analysis
| Autor: | Gabriela B. Thoennissen, Martin Kropff, Nils H. Thoennissen, Matthias Stelljes, Fleur Fritz, Georg Evers, Dennis Görlich, Wolfgang E. Berdel, Ulrike Bacher, Utz Krug, Anne-Christin Hüsken, Rolf M. Mesters, Jan-Henrik Mikesch, Anna Hansmeier, Carsten Bokemeyer, Carsten Müller-Tidow, Thomas Aufenberg |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Oncology
Melphalan Adult Male medicine.medical_specialty 610 Medicine & health Transplantation Autologous Disease-Free Survival Cohort Studies 03 medical and health sciences 0302 clinical medicine Autologous stem-cell transplantation Internal medicine medicine Humans Antineoplastic Agents Alkylating Multiple myeloma Lenalidomide Aged Retrospective Studies Bortezomib business.industry Induction chemotherapy Antineoplastic Protocols Hematology General Medicine Induction Chemotherapy Middle Aged medicine.disease Prognosis Combined Modality Therapy Thalidomide Regimen 030220 oncology & carcinogenesis Female business Multiple Myeloma 030215 immunology medicine.drug Stem Cell Transplantation |
| Zdroj: | Thoennissen, Gabriela B; Görlich, Dennis; Bacher, Vera Ulrike; Aufenberg, Thomas; Hüsken, Anne-Christin; Hansmeier, Anna Antonia; Evers, Georg; Mikesch, Jan-Henrik; Fritz, Fleur; Bokemeyer, Carsten; Müller-Tidow, Carsten; Stelljes, Matthias; Mesters, Rolf M; Krug, Utz; Kropff, Martin H; Thoennissen, Nils H; Berdel, Wolfgang E (2017). Autologous Stem Cell Transplantation in Multiple Myeloma in the Era of Novel Drug Induction: A Retrospective Single-Center Analysis. Acta haematologica, 137(3), pp. 163-172. Karger 10.1159/000463534 |
| DOI: | 10.7892/boris.100072 |
| Popis: | Within this retrospective single-center study, we analyzed the survival of 320 multiple myeloma (MM) patients receiving melphalan high-dose chemotherapy (HDCT) and either single (n = 286) or tandem (n = 34) autologous stem cell transplantation (ASCT) from 1996 to 2012. Additionally, the impact of novel induction regimens was assessed. Median follow-up was 67 months, median overall survival (OS) 62 months, median progression-free survival (PFS) 33 months (95% CI 27-39), and treatment-related death (TRD) 3%. Multivariate analysis revealed age ≥60 years (p = 0.03) and stage 3 according to the International Staging System (p = 0.006) as adverse risk factors regarding PFS. Median OS was significantly better in newly diagnosed MM patients receiving induction therapy with novel agents, e.g., bortezomib, thalidomide, or lenalidomide, compared with a traditional regimen (69 vs. 58 months; p = 0.01). More patients achieved at least a very good partial remission in the period from 2005 to 2012 than from 1996 to 2004 (65 vs. 30%; p < 0.001), with a longer median OS in the later period (71 vs. 52 months, p = 0.027). In conclusion, our analysis confirms HDCT-ASCT as an effective therapeutic strategy in an unselected large myeloma patient cohort with a low TRD rate and improved prognosis due to novel induction strategies. |
| Databáze: | OpenAIRE |
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