Abstract
Background and objectives: High-dose chemotherapy (HDT) with autologous peripheral blood progenitor cell (PBPC) transplant has been increasingly used for newly diagnosed multiple myeloma (MM) in recent years. Presently available results suggest an improvement in the complete remission rate and survival as compared to conventional chemotherapy. However, there is no plateau in the survival curves, and experiments with new treatment schedules and conditioning regimens are warranted. Design and methods: In a non-randomised controlled trial, 20 patients underwent three-step HDT following conventional vineristine/doxo ulicin/dexamethasone (VAD)-based induction. In the intensification phase patients received high-dose cyclophosphamide (HD-CY), high-dose etoposide (HD-VP), and mitoxantrone (NOV) plus melphalan (L-PAM) with haemopoietic rescue. Maintenance treatment with interferon was given until relapse. Actuarial overall survival (OS) and event-free survival (EFS) curves were plotted according to the method of Kaplan and Meier. In five of the eight patients achieving complete remission (CR), the molecular disease was monitored by polymerase chain reaction technique (PCR). Results: Overall 18/20 (90%) patients responded, with a CR rate of 40%. After an average follow-up of 40 months, median EFS and OS are 25.5 and 44.6 months, respectively. Monoclonal cells were detectable in the post-treatment bone marrow and in the aphereses of the five CR patients monitored by PCR. Conclusion: The present three-step HDT regimen, including conditioning with mitoxantrone and melphalan, proved to be feasible and safe. Our results are in agreement with the hypothesis that HDT results in an increased remission rate and in prolonged survival in newly diagnosed MM, but a cure is unlikely.
| Original language | English |
|---|---|
| Pages (from-to) | 101-106 |
| Number of pages | 6 |
| Journal | European Journal of Haematology |
| Volume | 68 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 2002 |
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Keywords
- Autologous transplantation
- High-dose chemotherapy
- Multiple myeloma
- Peripheral blood progenitor cell
ASJC Scopus subject areas
- Hematology
Cite this
Three-step high-dose sequential chemotherapy in patients with newly diagnosed multiple myeloma. / Ballestrero, Alberto; Ferrando, Fabio; Miglino, Maurizio; Clavio, Marino; Gonella, Roberta; Garuti, Anna; Grasso, Raffaella; Ghio, Riccardo; Balleari, Enrico; Gobbi, Marco; Patrone, Franco.
In: European Journal of Haematology, Vol. 68, No. 2, 2002, p. 101-106.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Three-step high-dose sequential chemotherapy in patients with newly diagnosed multiple myeloma
AU - Ballestrero, Alberto
AU - Ferrando, Fabio
AU - Miglino, Maurizio
AU - Clavio, Marino
AU - Gonella, Roberta
AU - Garuti, Anna
AU - Grasso, Raffaella
AU - Ghio, Riccardo
AU - Balleari, Enrico
AU - Gobbi, Marco
AU - Patrone, Franco
PY - 2002
Y1 - 2002
N2 - Background and objectives: High-dose chemotherapy (HDT) with autologous peripheral blood progenitor cell (PBPC) transplant has been increasingly used for newly diagnosed multiple myeloma (MM) in recent years. Presently available results suggest an improvement in the complete remission rate and survival as compared to conventional chemotherapy. However, there is no plateau in the survival curves, and experiments with new treatment schedules and conditioning regimens are warranted. Design and methods: In a non-randomised controlled trial, 20 patients underwent three-step HDT following conventional vineristine/doxo ulicin/dexamethasone (VAD)-based induction. In the intensification phase patients received high-dose cyclophosphamide (HD-CY), high-dose etoposide (HD-VP), and mitoxantrone (NOV) plus melphalan (L-PAM) with haemopoietic rescue. Maintenance treatment with interferon was given until relapse. Actuarial overall survival (OS) and event-free survival (EFS) curves were plotted according to the method of Kaplan and Meier. In five of the eight patients achieving complete remission (CR), the molecular disease was monitored by polymerase chain reaction technique (PCR). Results: Overall 18/20 (90%) patients responded, with a CR rate of 40%. After an average follow-up of 40 months, median EFS and OS are 25.5 and 44.6 months, respectively. Monoclonal cells were detectable in the post-treatment bone marrow and in the aphereses of the five CR patients monitored by PCR. Conclusion: The present three-step HDT regimen, including conditioning with mitoxantrone and melphalan, proved to be feasible and safe. Our results are in agreement with the hypothesis that HDT results in an increased remission rate and in prolonged survival in newly diagnosed MM, but a cure is unlikely.
AB - Background and objectives: High-dose chemotherapy (HDT) with autologous peripheral blood progenitor cell (PBPC) transplant has been increasingly used for newly diagnosed multiple myeloma (MM) in recent years. Presently available results suggest an improvement in the complete remission rate and survival as compared to conventional chemotherapy. However, there is no plateau in the survival curves, and experiments with new treatment schedules and conditioning regimens are warranted. Design and methods: In a non-randomised controlled trial, 20 patients underwent three-step HDT following conventional vineristine/doxo ulicin/dexamethasone (VAD)-based induction. In the intensification phase patients received high-dose cyclophosphamide (HD-CY), high-dose etoposide (HD-VP), and mitoxantrone (NOV) plus melphalan (L-PAM) with haemopoietic rescue. Maintenance treatment with interferon was given until relapse. Actuarial overall survival (OS) and event-free survival (EFS) curves were plotted according to the method of Kaplan and Meier. In five of the eight patients achieving complete remission (CR), the molecular disease was monitored by polymerase chain reaction technique (PCR). Results: Overall 18/20 (90%) patients responded, with a CR rate of 40%. After an average follow-up of 40 months, median EFS and OS are 25.5 and 44.6 months, respectively. Monoclonal cells were detectable in the post-treatment bone marrow and in the aphereses of the five CR patients monitored by PCR. Conclusion: The present three-step HDT regimen, including conditioning with mitoxantrone and melphalan, proved to be feasible and safe. Our results are in agreement with the hypothesis that HDT results in an increased remission rate and in prolonged survival in newly diagnosed MM, but a cure is unlikely.
KW - Autologous transplantation
KW - High-dose chemotherapy
KW - Multiple myeloma
KW - Peripheral blood progenitor cell
UR - http://www.scopus.com/inward/record.url?scp=0036250841&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036250841&partnerID=8YFLogxK
U2 - 10.1034/j.1600-0609.2002.01572.x
DO - 10.1034/j.1600-0609.2002.01572.x
M3 - Article
C2 - 12038448
AN - SCOPUS:0036250841
VL - 68
SP - 101
EP - 106
JO - European Journal of Haematology
JF - European Journal of Haematology
SN - 0902-4441
IS - 2
ER -