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Prepublished online as a Blood First Edition Paper on November 27, 2002; DOI 10.1182/blood-2002-03-0889. This Article Full Text (PDF) All Versions of this Article: 2002-03-0889v1 101/6/2144    most recent Alert me when this article is cited Alert me if a correction is posted 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 Segeren, C. M Articles by Lokhorst, H. M Search for Related Content PubMed PubMed Citation Articles by Segeren, C. M Articles by Lokhorst, H. M Social Bookmarking                   What's this? Submitted March 20, 2002 Accepted November 22, 2002 OVERALL AND EVENT-FREE SURVIVAL ARE NOT IMPROVED BY THE USE OF MYELO-ABLATIVE THERAPY FOLLOWING INTENSIFIED CHEMOTHERAPY IN PREVIOUSLY UNTREATED MULTIPLE MYELOMA PATIENTS: A PROSPECTIVE RANDOMIZED PHASE III STUDY Christine M Segeren*, Pieter Sonneveld, Bronno van der Holt, Edo Vellenga, Alexandra J Crookewit, Gregor E G Verhoef, Jan J Cornelissen, Martijn R Schaafsma, Marinus H van Oers, Pierre W Wijermans, Willem E Fibbe, Shulamit Wittebol, Harry C Schouten, Marinus van Marwijk Kooy, Douwe H Biesma, Joke W Baars, Rosalyn Slater, Monique M C Steijaert, Ivon Buijt, and Henk M Lokhorst Dutch-Belgian Hemato-Oncology Cooperative Study Group (HOVON), Erasmus Medical Center Rotterdam (Erasmus MC) and University Medical Center Utrecht (UMCU), The Netherlands Dutch Working Party on Cancer Genetics and Cytogenics (NWKGC), The Netherlands * Corresponding author; email: c.m.segeren{at}lumc.nl. We compared the efficacy of intensified chemotherapy followed by myelo-ablative therapy and autologous stem cell rescue with intensified chemotherapy alone in newly diagnosed with multiple myeloma. 261 eligible patients with stage II/III multiple myeloma below 66 years were randomized after remission induction therapy with VAD to receive intensified chemotherapy, i.e., melphalan 140 mg/m2 iv divided in 2 doses of 70 mg/m2 iv (IDM) without stem cell rescue (n = 129) or the same regimen followed by myelo-ablative therapy consisting of cyclophosphamide, total body irradiation and autologous stem cell reinfusion (n = 132). Interferon--2a was given as maintenance. Seventy-nine percent of patients received both cycles of IDM and 79% of allocated patients actually received myelo-ablative treatment. The response rate (CR plus PR) was 88% in the intensified chemotherapy group versus 95% in the myelo-ablative treatment group. CR was significantly higher after myelo-ablative therapy (13% versus 29%; P = .002). With a median follow up of 33 months (range: 8-65 months), the event-free survival (EFS) was not different between both treatments (median 21 months versus 22 months; P = .28). Time to progression (TTP) was significantly longer after myelo-ablative treatment (25 months versus 31 months; P = .04). The overall survival (OS) was not different (50 versus 47 months; P = .41). Intensified chemotherapy followed by myelo-ablative therapy as first line treatment for multiple myeloma resulted in a higher CR rate and a longer TTP when compared to intensified chemotherapy alone. However, it did not result in a better EFS and OS. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: S. Wang, G. Tricot, L. Shi, W. Xiong, Z. Zeng, H. Xu, M. Zangari, B. Barlogie, J. D. Shaughnessy Jr, and F. 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