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Tandem Autologous Stem Cell Transplantation for Multiple Myeloma Patients Based on Response to Their First Transplant—A Prospective Phase II Study
In this prospective phase II clinical trial, multiple myeloma (MM) patients were randomized to receive a second (tandem) autologous stem cell transplantation (ASCT) based on whether they achieved a partial response or worse (≤PR) following initial ASCT (ASCT1). Patients who achieved a very good part...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Libertas Academica
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4159376/ https://www.ncbi.nlm.nih.gov/pubmed/25232286 http://dx.doi.org/10.4137/CMO.S16835 |
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author | Byrne, Michael Salmasinia, Donya Leather, Helen Cogle, Christopher R Davis, Amy Hsu, Jack W Wiggins, Laura Chang, Myron N An, Qi Wingard, John R Moreb, Jan S |
author_facet | Byrne, Michael Salmasinia, Donya Leather, Helen Cogle, Christopher R Davis, Amy Hsu, Jack W Wiggins, Laura Chang, Myron N An, Qi Wingard, John R Moreb, Jan S |
author_sort | Byrne, Michael |
collection | PubMed |
description | In this prospective phase II clinical trial, multiple myeloma (MM) patients were randomized to receive a second (tandem) autologous stem cell transplantation (ASCT) based on whether they achieved a partial response or worse (≤PR) following initial ASCT (ASCT1). Patients who achieved a very good partial response or better (≥VGPR) had salvage ASCT at relapse. Seventy-five patients received conditioning therapy and ASCT1. A total of 44 patients (59%) achieved ≥VGPR, whereas 31 patients entered ≤PR and were offered tandem ASCT. In all, 20 patients agreed to tandem ASCT. Demographic and clinical characteristics were similar between the two cohorts except for median lactate dehydrogenase (LDH) (P = 0.0141) and percentage of marrow plasma cells before ASCT1 (P = 0.0047), both lower in the ≥VGPR group. Intent to treat analysis showed that patients who achieved ≥VGPR to ASCT1 had a trend toward improved progression-free survival (PFS) (37 vs. 26 months, P = 0.078) and superior overall survival (OS) (not reached vs. 50 months, P = 0.0073). Patients with ≤PR who declined tandem transplantation had shortened PFS (20 vs. 28 months, P = 0.05) but similar OS (53 vs. 57.5 months, P = 0.29) compared to those who received it. Thus, a favorable clinical response to ASCT1 identifies a low-risk group with superior long-term prognosis despite similar PFS. |
format | Online Article Text |
id | pubmed-4159376 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Libertas Academica |
record_format | MEDLINE/PubMed |
spelling | pubmed-41593762014-09-17 Tandem Autologous Stem Cell Transplantation for Multiple Myeloma Patients Based on Response to Their First Transplant—A Prospective Phase II Study Byrne, Michael Salmasinia, Donya Leather, Helen Cogle, Christopher R Davis, Amy Hsu, Jack W Wiggins, Laura Chang, Myron N An, Qi Wingard, John R Moreb, Jan S Clin Med Insights Oncol Original Research In this prospective phase II clinical trial, multiple myeloma (MM) patients were randomized to receive a second (tandem) autologous stem cell transplantation (ASCT) based on whether they achieved a partial response or worse (≤PR) following initial ASCT (ASCT1). Patients who achieved a very good partial response or better (≥VGPR) had salvage ASCT at relapse. Seventy-five patients received conditioning therapy and ASCT1. A total of 44 patients (59%) achieved ≥VGPR, whereas 31 patients entered ≤PR and were offered tandem ASCT. In all, 20 patients agreed to tandem ASCT. Demographic and clinical characteristics were similar between the two cohorts except for median lactate dehydrogenase (LDH) (P = 0.0141) and percentage of marrow plasma cells before ASCT1 (P = 0.0047), both lower in the ≥VGPR group. Intent to treat analysis showed that patients who achieved ≥VGPR to ASCT1 had a trend toward improved progression-free survival (PFS) (37 vs. 26 months, P = 0.078) and superior overall survival (OS) (not reached vs. 50 months, P = 0.0073). Patients with ≤PR who declined tandem transplantation had shortened PFS (20 vs. 28 months, P = 0.05) but similar OS (53 vs. 57.5 months, P = 0.29) compared to those who received it. Thus, a favorable clinical response to ASCT1 identifies a low-risk group with superior long-term prognosis despite similar PFS. Libertas Academica 2014-09-03 /pmc/articles/PMC4159376/ /pubmed/25232286 http://dx.doi.org/10.4137/CMO.S16835 Text en © 2014 the author(s), publisher and licensee Libertas Academica Ltd. This is an open access article published under the Creative Commons CC-BY-NC 3.0 License. |
spellingShingle | Original Research Byrne, Michael Salmasinia, Donya Leather, Helen Cogle, Christopher R Davis, Amy Hsu, Jack W Wiggins, Laura Chang, Myron N An, Qi Wingard, John R Moreb, Jan S Tandem Autologous Stem Cell Transplantation for Multiple Myeloma Patients Based on Response to Their First Transplant—A Prospective Phase II Study |
title | Tandem Autologous Stem Cell Transplantation for Multiple Myeloma Patients Based on Response to Their First Transplant—A Prospective Phase II Study |
title_full | Tandem Autologous Stem Cell Transplantation for Multiple Myeloma Patients Based on Response to Their First Transplant—A Prospective Phase II Study |
title_fullStr | Tandem Autologous Stem Cell Transplantation for Multiple Myeloma Patients Based on Response to Their First Transplant—A Prospective Phase II Study |
title_full_unstemmed | Tandem Autologous Stem Cell Transplantation for Multiple Myeloma Patients Based on Response to Their First Transplant—A Prospective Phase II Study |
title_short | Tandem Autologous Stem Cell Transplantation for Multiple Myeloma Patients Based on Response to Their First Transplant—A Prospective Phase II Study |
title_sort | tandem autologous stem cell transplantation for multiple myeloma patients based on response to their first transplant—a prospective phase ii study |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4159376/ https://www.ncbi.nlm.nih.gov/pubmed/25232286 http://dx.doi.org/10.4137/CMO.S16835 |
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