TY - JOUR
T1 - Superiority of thalidomide and dexamethasone over vincristine-doxorubicin- dexamethasone (VAD) as primary therapy in preparation for autologous transplantation for multiple myeloma
AU - Cavo, Michele
AU - Zamagni, Elena
AU - Tosi, Patrizia
AU - Tacchetti, Paola
AU - Cellini, Claudia
AU - Cangini, Delia
AU - De Vivo, Antonio
AU - Testoni, Nicoletta
AU - Nicci, Chiara
AU - Terragna, Carolina
AU - Grafone, Tiziana
AU - Perrone, Giulia
AU - Ceccolini, Michela
AU - Tura, Sante
AU - Baccarani, Michele
PY - 2005/7/1
Y1 - 2005/7/1
N2 - The aim of the present study was to compare thalidomide-dexamethasone (Thal-Dex) and vincristine-doxorubicin-dexamethasone (VAD) as primary therapy in preparation for autologous peripheral blood stem-cell (PBSC) transplantation for multiple myeloma (MM). For this purpose, we performed a retrospective matched case-control analysis of 200 patients who entered 2 consecutive studies from 1996 to 2004 and received Thal-Dex (n = 100) or VAD (n = 100) administered for 4 months before collection of PBSCs and autologous transplantation. Matching criteria included age, clinical stage, and serum β2- microglobulin levels. In comparison with VAD, Thal-Dex resulted in a significantly higher response rate (52% versus 76%, respectively; P <.001) and effected more profound reduction in myeloma cell mass of both immunoglobulin G (IgG; P = .02) and IgA (P = .03) type. More frequent: toxicities included nonfatal deep vein thrombosis with Thal-Dex (15%) and granulocytopenia with VAD (12%). In each of the 2 treatment groups, 91% of patients proceeded to PBSC mobilization. The median number of collected CD34+ cells was 7.85 × 106/kg in the Thal-Dex group and 10.5 × 10 6/kg in the control group. Thal-Dex may be considered an effective and relatively well-tolerated oral alternative to the more complex VAD regimen as front-line therapy for MM patients who are candidates for subsequent autologous transplantation.
AB - The aim of the present study was to compare thalidomide-dexamethasone (Thal-Dex) and vincristine-doxorubicin-dexamethasone (VAD) as primary therapy in preparation for autologous peripheral blood stem-cell (PBSC) transplantation for multiple myeloma (MM). For this purpose, we performed a retrospective matched case-control analysis of 200 patients who entered 2 consecutive studies from 1996 to 2004 and received Thal-Dex (n = 100) or VAD (n = 100) administered for 4 months before collection of PBSCs and autologous transplantation. Matching criteria included age, clinical stage, and serum β2- microglobulin levels. In comparison with VAD, Thal-Dex resulted in a significantly higher response rate (52% versus 76%, respectively; P <.001) and effected more profound reduction in myeloma cell mass of both immunoglobulin G (IgG; P = .02) and IgA (P = .03) type. More frequent: toxicities included nonfatal deep vein thrombosis with Thal-Dex (15%) and granulocytopenia with VAD (12%). In each of the 2 treatment groups, 91% of patients proceeded to PBSC mobilization. The median number of collected CD34+ cells was 7.85 × 106/kg in the Thal-Dex group and 10.5 × 10 6/kg in the control group. Thal-Dex may be considered an effective and relatively well-tolerated oral alternative to the more complex VAD regimen as front-line therapy for MM patients who are candidates for subsequent autologous transplantation.
UR - http://www.scopus.com/inward/record.url?scp=22044452126&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=22044452126&partnerID=8YFLogxK
U2 - 10.1182/blood-2005-02-0522
DO - 10.1182/blood-2005-02-0522
M3 - Article
C2 - 15761019
AN - SCOPUS:22044452126
VL - 106
SP - 35
EP - 39
JO - Blood
JF - Blood
SN - 0006-4971
IS - 1
ER -