dc.contributor.author
Straka, Christian
dc.contributor.author
Liebisch, Peter
dc.contributor.author
Salwender, Hans
dc.contributor.author
Hennemann, Burkhard
dc.contributor.author
Metzner, Bernd
dc.contributor.author
Knop, Stefan
dc.contributor.author
Sezer, Orhan [u.v.m.]
dc.date.accessioned
2018-06-08T10:36:02Z
dc.date.available
2017-03-30T09:27:21.564Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/20716
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-24015
dc.description.abstract
Autologous transplantation is controversial for older patients with multiple
myeloma. The role of age-adjusted high-dose melphalan and the impact of
induction chemotherapy cycles is still unclear. A total of 434 patients aged
60–70 years were randomly assigned to 4 cycles of standard anthracycline-based
induction chemotherapy or no induction. For all patients, double autologous
transplantation after melphalan 140 mg/m2 (MEL140) was planned. The primary
end point was progression-free survival. Of 420 eligible patients, 85%
received a first transplant and 69% completed double transplantation.
Treatment duration was short with a median of 7.7 months with induction
chemotherapy cycles and 4.6 months without induction. On an intention-to-treat
basis, median progression-free survival with induction chemotherapy cycles
(207 patients) was 21.4 months versus 20.0 months with no induction cycles
(213 patients) (hazard ratio 1.04, 95% confidence interval 0.84–1.28; P=0.36).
Per protocol, progression-free survival was 23.7 months versus 23.0 months
(P=0.28). Patients aged 65 years or over (55%) did not have an inferior
outcome. Patients with low-risk cytogenetics [absence of del17p13, t(4;14) and
1q21 gains] showed a favorable overall survival and included the patients with
sustained first remission. MEL140 was associated with a low rate of severe
mucositis (10%) and treatment-related deaths (1%). Based on hazard ratio, the
short treatment arm consisting of mobilization chemotherapy and tandem MEL140
achieved 96% of the progression-free survival, demonstrating its value as an
independent component of therapy in older patients with multiple myeloma who
are considered fit for autologous transplantation. (clinicaltrials.gov
identifier: 02288741)
en
dc.rights.uri
http://www.haematologica.org/information-for-authors
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit
dc.title
Autotransplant with and without induction chemotherapy in older multiple
myeloma patients
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation
Haematologica. - 101 (2016), 11, S. 1398-1406
dc.title.subtitle
long-term outcome of a randomized trial
dcterms.bibliographicCitation.doi
10.3324/haematol.2016.151860
dcterms.bibliographicCitation.url
http://www.haematologica.org/content/101/11/1398
refubium.affiliation
Charité - Universitätsmedizin Berlin
de
refubium.mycore.fudocsId
FUDOCS_document_000000026743
refubium.resourceType.isindependentpub
no
refubium.mycore.derivateId
FUDOCS_derivate_000000007984
dcterms.accessRights.openaire
open access