Response to induction chemotherapy is not essential to obtain survival benefit from high-dose melphalan and autotransplantation in myeloma
| العنوان: | Response to induction chemotherapy is not essential to obtain survival benefit from high-dose melphalan and autotransplantation in myeloma |
|---|---|
| المؤلفون: | Samar Kulkarni, R. L. Powles, Jennifer Treleaven, Seema Singhal, Jayesh Mehta, Bhawna Sirohi |
| المصدر: | Bone Marrow Transplantation. 30:673-679 |
| بيانات النشر: | Springer Science and Business Media LLC, 2002. |
| سنة النشر: | 2002 |
| مصطلحات موضوعية: | Adult, Male, Melphalan, Oncology, medicine.medical_specialty, animal structures, medicine.medical_treatment, Transplantation, Autologous, Disease-Free Survival, Recurrence, immune system diseases, hemic and lymphatic diseases, Internal medicine, Immunopathology, Antineoplastic Combined Chemotherapy Protocols, Humans, Medicine, Longitudinal Studies, neoplasms, Multiple myeloma, Aged, Peripheral Blood Stem Cell Transplantation, Transplantation, Chemotherapy, business.industry, Remission Induction, High dose melphalan, Induction chemotherapy, Hematology, Middle Aged, medicine.disease, Autotransplantation, Surgery, Survival Rate, Treatment Outcome, Survival benefit, Multivariate Analysis, Female, Multiple Myeloma, business, medicine.drug |
| الوصف: | Two hundred and twenty-two myeloma patients autografted after 200 mg/m(2)melphalan were studied to examine the relationship between response to induction chemotherapy and outcome. Induction comprised cyclophosphamide, vincristine, doxorubicin and methylprednisolone (C-VAMP) every 3 weeks for one cycle beyond maximum response. 81% responded to C-VAMP (chemosensitive) with 40 complete (CR) and 139 partial (PR) remissions, and 43 did not respond (NR;50% reduction in paraprotein; primary refractory). Overall, 130 patients (59%) attained or remained in CR post-transplant; including 40% of NR, 53% of PR, and 97% of CR after C-VAMP (P0.0001). Amongst these 130 patients, the 5-year OS was independent of response to C-VAMP (NR 79%, PR 74%, CR 60%; P = 0.69). Similarly, among the 69 patients in PR post-transplant, the 5-year OS was independent of response to C-VAMP. In Cox analysis, lack of response to C-VAMP did not affect outcome significantly. These data show that lack of response to induction therapy does not automatically predict poor long-term outcome in myeloma, since a substantial proportion of these patients attain CR after autograft and enjoy extended survival. Myeloma patients should not be disqualified from an autograft based upon lack of response to induction chemotherapy. |
| تدمد: | 1476-5365 0268-3369 |
| DOI: | 10.1038/sj.bmt.1703717 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b8a56f6f2b1972106ccfe0cfb9a5e554 https://doi.org/10.1038/sj.bmt.1703717 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....b8a56f6f2b1972106ccfe0cfb9a5e554 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14765365 02683369 |
|---|---|
| DOI: | 10.1038/sj.bmt.1703717 |