Superiority of thalidomide and dexamethasone over vincristine-doxorubicin- dexamethasone (VAD) as primary therapy in preparation for autologous transplantation for multiple myeloma

Michele Cavo, Elena Zamagni, Patrizia Tosi, Paola Tacchetti, Claudia Cellini, Delia Cangini, Antonio De Vivo, Nicoletta Testoni, Chiara Nicci, Carolina Terragna, Tiziana Grafone, Giulia Perrone, Michela Ceccolini, Sante Tura, Michele Baccarani

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)35-39
Number of pages5
JournalBlood
Volume106
Issue number1
DOIs
Publication statusPublished - Jul 1 2005

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Thalidomide
Autologous Transplantation
Vincristine
Multiple Myeloma
Doxorubicin
Dexamethasone
Stem cells
Therapeutics
Blood
Immunoglobulin G
Hematopoietic Stem Cell Mobilization
Peripheral Blood Stem Cell Transplantation
Agranulocytosis
Venous Thrombosis
Immunoglobulin A
Toxicity
Control Groups
Serum

ASJC Scopus subject areas

  • Hematology

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Superiority of thalidomide and dexamethasone over vincristine-doxorubicin- dexamethasone (VAD) as primary therapy in preparation for autologous transplantation for multiple myeloma. / Cavo, Michele; Zamagni, Elena; Tosi, Patrizia; Tacchetti, Paola; Cellini, Claudia; Cangini, Delia; De Vivo, Antonio; Testoni, Nicoletta; Nicci, Chiara; Terragna, Carolina; Grafone, Tiziana; Perrone, Giulia; Ceccolini, Michela; Tura, Sante; Baccarani, Michele.

In: Blood, Vol. 106, No. 1, 01.07.2005, p. 35-39.

Research output: Contribution to journalArticle

Cavo, M, Zamagni, E, Tosi, P, Tacchetti, P, Cellini, C, Cangini, D, De Vivo, A, Testoni, N, Nicci, C, Terragna, C, Grafone, T, Perrone, G, Ceccolini, M, Tura, S & Baccarani, M 2005, 'Superiority of thalidomide and dexamethasone over vincristine-doxorubicin- dexamethasone (VAD) as primary therapy in preparation for autologous transplantation for multiple myeloma', Blood, vol. 106, no. 1, pp. 35-39. https://doi.org/10.1182/blood-2005-02-0522
Cavo, Michele ; Zamagni, Elena ; Tosi, Patrizia ; Tacchetti, Paola ; Cellini, Claudia ; Cangini, Delia ; De Vivo, Antonio ; Testoni, Nicoletta ; Nicci, Chiara ; Terragna, Carolina ; Grafone, Tiziana ; Perrone, Giulia ; Ceccolini, Michela ; Tura, Sante ; Baccarani, Michele. / Superiority of thalidomide and dexamethasone over vincristine-doxorubicin- dexamethasone (VAD) as primary therapy in preparation for autologous transplantation for multiple myeloma. In: Blood. 2005 ; Vol. 106, No. 1. pp. 35-39.
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abstract = "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.",
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T1 - Superiority of thalidomide and dexamethasone over vincristine-doxorubicin- dexamethasone (VAD) as primary therapy in preparation for autologous transplantation for multiple myeloma

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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

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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.

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