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Blood, 15 October 2008, Vol. 112, No. 8, pp. 3115-3121. Prepublished online as a Blood First Edition Paper on May 20, 2008; DOI 10.1182/blood-2008-03-145235. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2008-03-145235v1 112/8/3115    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 Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Barlogie, B. Articles by Crowley, J. Search for Related Content PubMed PubMed Citation Articles by Barlogie, B. Articles by Crowley, J. Related Collections Neoplasia Clinical Trials and Observations Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Thalidomide arm of Total Therapy 2 improves complete remission duration and survival in myeloma patients with metaphase cytogenetic abnormalities Bart Barlogie1, Mauricio Pineda-Roman1, Frits van Rhee1, Jeff Haessler2, Elias Anaissie1, Klaus Hollmig1, Yazan Alsayed1, Sarah Waheed1, Nathan Petty1, Joshua Epstein1, John D. Shaughnessy, Jr1, Guido Tricot1, Maurizio Zangari1, Jerome Zeldis3, Sol Barer3, and John Crowley2 1 Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock; 2 Cancer Research and Biostatistics, Seattle, WA; and 3 Celgene Corporation, Summit, NJ Total Therapy 2 examined the clinical benefit of adding thalidomide up-front to a tandem transplant regimen for newly diagnosed patients with multiple myeloma. When initially reported with a median follow-up of 42 months, complete response rate and event-free survival were superior among the 323 patients randomized to thalidomide, whereas overall survival was indistinguishable from that of the 345 patients treated on the control arm. With further follow-up currently at a median of 72 months, survival plots segregated 5 years after initiation of therapy in favor of thalidomide (P = .09), reaching statistical significance for the one third of patients exhibiting cytogenetic abnormalities (CAs; P = .02), a well-recognized adverse prognostic feature. The duration of complete remission was also superior in the cohort presenting with CAs such that, at 7 years from onset of complete remission, 45% remained relapse-free as opposed to 20% on the control arm (P = .05). These observations were confirmed when examined by multivariate analysis demonstrating that thalidomide reduced the hazard of death by 41% among patients with CA-positive disease (P = .008). Because two thirds of patients without CAs have remained alive at 7 years, the presently emerging separation in favor of thalidomide may eventually reach statistical significance as well. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Biology, treatment, and time Angela Dispenzieri Blood 2008 112: 2999-3000. [Full Text] [PDF] This article has been cited by other articles: M. Cavo, F. Di Raimondo, E. Zamagni, F. Patriarca, P. Tacchetti, A. F. Casulli, S. Volpe, G. Perrone, A. Ledda, M. Ceccolini, et al. Short-Term Thalidomide Incorporated Into Double Autologous Stem-Cell Transplantation Improves Outcomes in Comparison With Double Autotransplantation for Multiple Myeloma J. Clin. Oncol., October 20, 2009; 27(30): 5001 - 5007. [Abstract] [Full Text] [PDF] J.-L. Harousseau, M. Attal, and H. Avet-Loiseau The role of complete response in multiple myeloma Blood, October 8, 2009; 114(15): 3139 - 3146. [Abstract] [Full Text] [PDF] A. Hoering, J. Crowley, J. D Shaughnessy Jr, K. Hollmig, Y. Alsayed, J. Szymonifka, S. Waheed, B. Nair, F. van Rhee, E. Anaissie, et al. 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