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Blood, 1 July 2005, Vol. 106, No. 1, pp. 35-39. Prepublished online as a Blood First Edition Paper on March 10, 2005; DOI 10.1182/blood-2005-02-0522. This Article Full Text Full Text (PDF) All Versions of this Article: 2005-02-0522v1 106/1/35    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager patientINFORMation Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Cavo, M. Articles by Baccarani, M. Search for Related Content PubMed PubMed Citation Articles by Cavo, M. Articles by Baccarani, M. Related Collections Neoplasia Free Research Articles Clinical Trials and Observations Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Superiority of thalidomide and dexamethasone over vincristine-doxorubicindexamethasone (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, for the writing committee of the Bologna 2002 study From the Institute of Hematology and Medical Oncology "Seràgnoli," University of Bologna, Italy. 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 2-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 x 106/kg in the Thal-Dex group and 10.5 x 106/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. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Find additional patient-related information at: New Drug Combo Shows Promise for Multiple Myeloma - 4/15/05 Related Article in Blood Online: Multiple myeloma: the death of VAD as initial therapy S. Vincent Rajkumar Blood 2005 106: 2-3. [Full Text] [PDF] This article has been cited by other articles: H.-S. Eom, C.-K. Min, B.-S. Cho, S. Lee, J.-W. Lee, W.-S. Min, C.-C. Kim, M. Kim, and Y. Kim Retrospective Comparison of Bortezomib-containing Regimens with Vincristine-Doxorubicin-Dexamethasone (VAD) as Induction Treatment Prior to Autologous Stem Cell Transplantation for Multiple Myeloma Jpn. J. Clin. Oncol., July 1, 2009; 39(7): 449 - 455. [Abstract] [Full Text] [PDF] S. V. Rajkumar, L. Rosinol, M. Hussein, J. Catalano, W. Jedrzejczak, L. Lucy, M. Olesnyckyj, Z. Yu, R. Knight, J. B. Zeldis, et al. Multicenter, Randomized, Double-Blind, Placebo-Controlled Study of Thalidomide Plus Dexamethasone Compared With Dexamethasone As Initial Therapy for Newly Diagnosed Multiple Myeloma J. Clin. Oncol., May 1, 2008; 26(13): 2171 - 2177. [Abstract] [Full Text] [PDF] A. Palumbo, T. Facon, P. Sonneveld, J. Blade, M. Offidani, F. Gay, P. Moreau, A. Waage, A. Spencer, H. Ludwig, et al. Thalidomide for treatment of multiple myeloma: 10 years later Blood, April 15, 2008; 111(8): 3968 - 3977. [Abstract] [Full Text] [PDF] H. Brenner, A. Gondos, and D. Pulte Recent major improvement in long-term survival of younger patients with multiple myeloma Blood, March 1, 2008; 111(5): 2521 - 2526. [Abstract] [Full Text] [PDF] A. Abdelkefi, S. Ladeb, L. Torjman, T. B. Othman, A. Lakhal, N. B. Romdhane, H. E. Omri, M. Elloumi, H. Belaaj, R. Jeddi, et al. Single autologous stem-cell transplantation followed by maintenance therapy with thalidomide is superior to double autologous transplantation in multiple myeloma: results of a multicenter randomized clinical trial Blood, February 15, 2008; 111(4): 1805 - 1810. [Abstract] [Full Text] [PDF] R. Niesvizky, D. S. Jayabalan, P. J. Christos, J. R. Furst, T. Naib, S. Ely, J. Jalbrzikowski, R. N. Pearse, F. Zafar, K. Pekle, et al. BiRD (Biaxin [clarithromycin]/Revlimid [lenalidomide]/dexamethasone) combination therapy results in high complete- and overall-response rates in treatment-naive symptomatic multiple myeloma. Blood, February 1, 2008; 111(3): 1101 - 1109. [Abstract] [Full Text] [PDF] H. M. Lokhorst, I. Schmidt-Wolf, P. Sonneveld, B. van der Holt, H. Martin, R. Barge, U. Bertsch, J. Schlenzka, G. M.J. Bos, S. Croockewit, et al. Thalidomide in induction treatment increases the very good partial response rate before and after high-dose therapy in previously untreated multiple myeloma Haematologica, January 1, 2008; 93(1): 124 - 127. [Abstract] [Full Text] [PDF] L. Rosinol, A. Oriol, M. V. Mateos, A. Sureda, P. Garcia-Sanchez, N. Gutierrez, A. Alegre, J. J. Lahuerta, J. de la Rubia, C. Herrero, et al. Phase II Pethema Trial of Alternating Bortezomib and Dexamethasone As Induction Regimen Before Autologous Stem-Cell Transplantation in Younger Patients With Multiple Myeloma: Efficacy and Clinical Implications of Tumor Response Kinetics J. Clin. Oncol., October 1, 2007; 25(28): 4452 - 4458. [Abstract] [Full Text] [PDF] M. Q. Lacy, M. A. Gertz, A. Dispenzieri, S. R. Hayman, S. Geyer, B. Kabat, S. R. Zeldenrust, S. Kumar, P. R. Greipp, R. Fonseca, et al. Long-term Results of Response to Therapy, Time to Progression, and Survival With Lenalidomide Plus Dexamethasone in Newly Diagnosed Myeloma Mayo Clin. Proc., October 1, 2007; 82(10): 1179 - 1184. [Abstract] [Full Text] [PDF] K Zervas, D Mihou, E Katodritou, A Pouli, C. Mitsouli, A Anagnostopoulos, S Delibasi, M. Kyrtsonis, N Anagnostopoulos, E Terpos, et al. VAD-doxil versus VAD-doxil plus thalidomide as initial treatment for multiple myeloma: results of a multicenter randomized trial of the Greek myeloma study group Ann. Onc., August 1, 2007; 18(8): 1369 - 1375. [Abstract] [Full Text] [PDF] P. Sonneveld, B. van der Holt, C. M. Segeren, E. Vellenga, A. J. Croockewit, G. E.G. Verhoef, J. J. Cornelissen, M. R. Schaafsma, M. H.J. van Oers, P. W. Wijermans, et al. Intermediate-dose melphalan compared with myeloablative treatment in multiple myeloma: long-term follow-up of the Dutch Cooperative Group HOVON 24 trial Haematologica, July 1, 2007; 92(7): 928 - 935. [Abstract] [Full Text] [PDF] M. Cavo, P. Tosi, E. Zamagni, C. Cellini, P. Tacchetti, F. Patriarca, F. Di Raimondo, E. Volpe, S. Ronconi, D. Cangini, et al. Prospective, Randomized Study of Single Compared With Double Autologous Stem-Cell Transplantation for Multiple Myeloma: Bologna 96 Clinical Study J. Clin. Oncol., June 10, 2007; 25(17): 2434 - 2441. [Abstract] [Full Text] [PDF] E. Zamagni, C. Nanni, F. Patriarca, E. Englaro, P. Castellucci, O. Geatti, P. Tosi, P. Tacchetti, D. Cangini, G. Perrone, et al. A prospective comparison of 18F-fluorodeoxyglucose positron emission tomography-computed tomography, magnetic resonance imaging and whole-body planar radiographs in the assessment of bone disease in newly diagnosed multiple myeloma Haematologica, January 1, 2007; 92(1): 50 - 55. [Abstract] [Full Text] [PDF] M. Attal, P. Moreau, H. Avet-Loiseau, and J.-L. Harousseau Stem Cell Transplantation in Multiple Myeloma Hematology, January 1, 2007; 2007(1): 311 - 316. [Abstract] [Full Text] [PDF] P. Tosi, E. Zamagni, D. Cangini, P. Tacchetti, F. Di Raimondo, L. Catalano, A. D'Arco, S. Ronconi, C. Cellini, M. Offidani, et al. Osteonecrosis of the jaws in newly diagnosed multiple myeloma patients treated with zoledronic acid and thalidomide-dexamethasone. Blood, December 15, 2006; 108(12): 3951 - 3952. [Full Text] [PDF] G. Merlini Exciting new agents in multiple myeloma Blood, November 15, 2006; 108(10): 3235 - 3236. [Full Text] [PDF] M. Offidani, L. Corvatta, M.-N. Piersantelli, G. Visani, F. Alesiani, M. Brunori, P. Galieni, M. Catarini, M. Burattini, R. Centurioni, et al. Thalidomide, dexamethasone, and pegylated liposomal doxorubicin (ThaDD) for patients older than 65 years with newly diagnosed multiple myeloma Blood, October 1, 2006; 108(7): 2159 - 2164. [Abstract] [Full Text] [PDF] M. Q. Lacy Multiple Myeloma: New Options, New Challenges Mayo Clin. Proc., July 1, 2006; 81(7): 877 - 879. [Full Text] [PDF] B. Barlogie, G. Tricot, E. Rasmussen, E. Anaissie, F. van Rhee, M. Zangari, A. Fassas, K. Hollmig, M. Pineda-Roman, J. Shaughnessy, et al. Total therapy 2 without thalidomide in comparison with total therapy 1: role of intensified induction and posttransplantation consolidation therapies Blood, April 1, 2006; 107(7): 2633 - 2638. [Abstract] [Full Text] [PDF] M. Cavo and M. Baccarani The Changing Landscape of Myeloma Therapy N. Engl. J. Med., March 9, 2006; 354(10): 1076 - 1078. [Full Text] [PDF] B. Barlogie, R. A. Kyle, K. C. Anderson, P. R. Greipp, H. M. Lazarus, D. D. Hurd, J. McCoy, S. R. Dakhil, K. S. Lanier, R. A. Chapman, et al. Standard Chemotherapy Compared With High-Dose Chemoradiotherapy for Multiple Myeloma: Final Results of Phase III US Intergroup Trial S9321 J. Clin. Oncol., February 20, 2006; 24(6): 929 - 936. [Abstract] [Full Text] [PDF] S. V. Rajkumar, E. Blood, D. Vesole, R. Fonseca, and P. R. Greipp Phase III Clinical Trial of Thalidomide Plus Dexamethasone Compared With Dexamethasone Alone in Newly Diagnosed Multiple Myeloma: A Clinical Trial Coordinated by the Eastern Cooperative Oncology Group J. Clin. Oncol., January 20, 2006; 24(3): 431 - 436. [Abstract] [Full Text] [PDF] P. Richardson and K. Anderson Thalidomide and Dexamethasone: A New Standard of Care for Initial Therapy in Multiple Myeloma J. Clin. Oncol., January 20, 2006; 24(3): 334 - 336. [Full Text] [PDF] S. V. Rajkumar, S. R. Hayman, M. Q. Lacy, A. Dispenzieri, S. M. Geyer, B. Kabat, S. R. Zeldenrust, S. Kumar, P. R. Greipp, R. Fonseca, et al. Combination therapy with lenalidomide plus dexamethasone (Rev/Dex) for newly diagnosed myeloma Blood, December 15, 2005; 106(13): 4050 - 4053. [Abstract] [Full Text] [PDF] S. W. Lane, D. Gill, P. N. Mollee, and S. V. Rajkumar Role of VAD in the initial treatment of multiple myeloma Blood, November 15, 2005; 106(10): 3674 - 3675. [Full Text] [PDF] S. V. Rajkumar and R. A. Kyle Multiple Myeloma: Diagnosis and Treatment Mayo Clin. Proc., October 1, 2005; 80(10): 1371 - 1382. [Abstract] [PDF]

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