| Evaluation of the feasibility and efficacy of autologous stem cell transplantation in elderly patients with multiple myeloma. | |
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MedLine Citation:
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PMID: 23291675 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Objective The feasibility and efficacy of high-dose melphalan (HD-MEL) followed by autologous hematopoietic stem cell transplantation (auto-SCT) in elderly patients with multiple myeloma (MM) are discussed. Methods We retrospectively analyzed and compared the results of 25 elderly patients (aged 65-76 years, elderly group) and 63 control patients (aged 51-64 years, control group). Many patients received a vincristine and doxorubicin combined with dexamethasone (VAD) regimen (elderly group: 92%, control group: 78%) with autologous peripheral blood stem cells being harvested after the administration of chemotherapy with high-dose cyclophosphamide (elderly group: 72%, control group: 87%). Ten elderly patients received MEL at a dose of 100-120 mg/m(2), while 15 patients received MEL at a dose of 180-200 mg/m(2). Results Treatment-related deaths occurred in one elderly patient and two younger patients due to infections. The rate of achieving complete response (CR) or very good partial response (VGPR) was 60% in the elderly group and 83% in the control group. Progression-free survival from auto-SCT in the elderly group was similar to that observed in the control group (median 17.1 vs. 20.8 months, p=0.26), with the median overall survival (OS) from auto-SCT being 40.8 months in the former and 72.5 months in the latter group (p=0.07). When calculated from the beginning of induction treatment, the median OS of the elderly group was 47.0 months and the 3-year OS rate was 81%. Conclusion The current study provides evidence for the efficacy of auto-SCT in elderly MM patients. A prospective study of auto-SCT in elderly patients using strict eligibility criteria is required to evaluate the prolongation of survival in the era of novel agents. |
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Authors:
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Tsuyoshi Muta; Toshihiro Miyamoto; Tomoaki Fujisaki; Yuju Ohno; Tomohiko Kamimura; Koji Kato; Katsuto Takenaka; Hiromi Iwasaki; Tetsuya Eto; Yasushi Takamatsu; Takanori Teshima; Koichi Akashi; |
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Publication Detail:
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Type: Journal Article Date: 2013-01-01 |
Journal Detail:
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Title: Internal medicine (Tokyo, Japan) Volume: 52 ISSN: 1349-7235 ISO Abbreviation: Intern. Med. Publication Date: 2013 |
Date Detail:
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Created Date: 2013-01-07 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9204241 Medline TA: Intern Med Country: Japan |
Other Details:
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Languages: eng Pagination: 63-70 Citation Subset: IM |
Affiliation:
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Department of Hematology/Oncology, Kyushu University Hospital, Japan. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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