Document Detail

Impact of pretransplant therapy in patients with newly diagnosed myeloma undergoing autologous SCT.
MedLine Citation:
PMID:  18332915     Owner:  NLM     Status:  MEDLINE    
Autologous SCT (ASCT) remains an effective therapy for eligible patients with myeloma. Previous studies have suggested a lack of impact of the initial therapy on the outcome after ASCT. It is not clear if incorporation of new agents in the initial treatment regimens will have any impact on the outcome after ASCT. We studied 472 patients undergoing ASCT within 12 months of diagnosis to assess the effect of initial therapy on the outcome after ASCT. Patients received initial therapy with vincristine, adriamycin and dexamethasone (VAD), dexamethasone, thalidomide and dexamethasone or lenalidomide and dexamethasone. While patients treated with dexamethasone alone had higher disease burden at ASCT, no differences were observed in the response rates to ASCT, post transplant complications or treatment-related mortality among the groups. The median time to progression after ASCT was 27.1, 24.7, 21.1 months and did not reach the VAD, Dex, Thal-Dex and Len-Dex group, respectively, P=0.11. The median overall survival from ASCT was 62 months for VAD, 69.6 months for Dex and were not reached for Thal-Dex and Len-Dex groups, P=0.2. For patients undergoing early ASCT for myeloma, the nature of initial treatment utilized has no long-term impact on the outcome of ASCT.
S K Kumar; D Dingli; A Dispenzieri; M Q Lacy; S R Hayman; F K Buadi; S V Rajkumar; M R Litzow; M A Gertz
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-03-10
Journal Detail:
Title:  Bone marrow transplantation     Volume:  41     ISSN:  0268-3369     ISO Abbreviation:  Bone Marrow Transplant.     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-06-25     Completed Date:  2008-10-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8702459     Medline TA:  Bone Marrow Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  1013-9     Citation Subset:  IM    
Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN 55905, USA.
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MeSH Terms
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
Dexamethasone / administration & dosage
Disease-Free Survival
Hematopoietic Stem Cell Transplantation / methods*
Kaplan-Meiers Estimate
Middle Aged
Multiple Myeloma / therapy*
Remission Induction / methods
Retrospective Studies
Thalidomide / administration & dosage,  analogs & derivatives
Transplantation Conditioning / methods
Transplantation, Autologous
Reg. No./Substance:
191732-72-6/lenalidomide; 50-02-2/Dexamethasone; 50-35-1/Thalidomide

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