Document Detail


Short-term thalidomide incorporated into double autologous stem-cell transplantation improves outcomes in comparison with double autotransplantation for multiple myeloma.
MedLine Citation:
PMID:  19720903     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To assess potential benefits with thalidomide incorporated into double autologous stem-cell transplantation (ASCT) for younger patients with newly diagnosed multiple myeloma (MM). PATIENTS AND METHODS: One hundred thirty-five patients who received thalidomide from induction until the second ASCT were retrospectively analyzed in comparison with an equal number of pair mates treated with double ASCT not including thalidomide. RESULTS: On an intention-to-treat basis, the addition of thalidomide to double ASCT effected a significant improvement in the rate (68% v 49%; P = .001) and duration (62% v 33% at 4 years; P < .001) of at least very good partial response (VGPR), time to progression (TTP; 61% v 41% at 4 years; P < .001) and progression-free survival (PFS; 51% v 31% at 4 years; P = .001). A trend was also noted for extended overall survival (OS) among thalidomide-treated patients (69% at 5 years v 53% for the control group), although the difference between the two groups was not statistically significant (P = .07). Benefits with thalidomide in increasing the rate of VGPR or better response, TTP, and PFS were confirmed in a multivariate analysis. Median OS after relapse was 24 months for patients receiving thalidomide added to double ASCT and 25 months for the control group. Overall, 17% of patients discontinued thalidomide, including 8% because of drug-related adverse events. CONCLUSION: In comparison with double ASCT, the addition of first-line thalidomide to double ASCT improved clinical outcomes. Short-term thalidomide was generally well tolerated and had no adverse impact on postrelapse survival.
Authors:
Michele Cavo; Francesco Di Raimondo; Elena Zamagni; Francesca Patriarca; Paola Tacchetti; Antonio Francesco Casulli; Silvestro Volpe; Giulia Perrone; Antonio Ledda; Michela Ceccolini; Catello Califano; Catia Bigazzi; Massimo Offidani; Piero Stefani; Filippo Ballerini; Mauro Fiacchini; Antonio de Vivo; Annamaria Brioli; Patrizia Tosi; Michele Baccarani
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-08-31
Journal Detail:
Title:  Journal of clinical oncology : official journal of the American Society of Clinical Oncology     Volume:  27     ISSN:  1527-7755     ISO Abbreviation:  J. Clin. Oncol.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-19     Completed Date:  2009-11-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309333     Medline TA:  J Clin Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  5001-7     Citation Subset:  IM    
Affiliation:
Dipartimento di Ematologia e Scienze Oncologiche Seràgnoli, Istituto di Ematologia Seràgnoli, Università di Bologna, Bologna, Italy. michele.cavo@unibo.it
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MeSH Terms
Descriptor/Qualifier:
Antineoplastic Agents / administration & dosage*
Antineoplastic Combined Chemotherapy Protocols / administration & dosage
Busulfan / administration & dosage
Cyclophosphamide / administration & dosage
Dexamethasone / administration & dosage
Doxorubicin / administration & dosage
Granulocyte Colony-Stimulating Factor / administration & dosage
Humans
Interferons / administration & dosage
Melphalan / administration & dosage
Multiple Myeloma / drug therapy,  therapy*
Randomized Controlled Trials as Topic
Retrospective Studies
Stem Cell Transplantation / methods*
Thalidomide / administration & dosage*
Transplantation, Autologous
Treatment Outcome
Vincristine / administration & dosage
Chemical
Reg. No./Substance:
0/Antineoplastic Agents; 0/VAD I protocol; 143011-72-7/Granulocyte Colony-Stimulating Factor; 148-82-3/Melphalan; 23214-92-8/Doxorubicin; 50-02-2/Dexamethasone; 50-18-0/Cyclophosphamide; 50-35-1/Thalidomide; 55-98-1/Busulfan; 57-22-7/Vincristine; 9008-11-1/Interferons

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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