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Blood, 1 December 2005, Vol. 106, No. 12, pp. 3755-3759. Prepublished online as a Blood First Edition Paper on August 16, 2005; DOI 10.1182/blood-2005-03-1301. This Article Full Text (PDF) All Versions of this Article: 2005-03-1301v1 106/12/3755    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 Blade, J. Articles by San Miguel, J. Search for Related Content PubMed PubMed Citation Articles by Blade, J. Articles by San Miguel, J. Related Collections Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted March 31, 2005 Accepted July 11, 2005 High-dose therapy intensification versus continued standard chemotherapy in multiple myeloma patients responding to the initial chemotherapy: long term results from a prospective randomized trial from the Spanish cooperative group PETHEMA Joan Blade*, Laura Rosinol, Ana Sureda, Jose M Ribera, Joaquin Diaz-Mediavilla, Jose Garcia-Larana, M V Mateos, Luis Palomera, Javier Fernandez-Calvo, Josep M Marti, Pilar Giraldo, Felix Carbonell, Manel Callis, Jesus Trujillo, Santiago Gardella, M J Moro, Abelardo Barez, Alfons Soler, Llorenc Font, Montserrat Fontanillas, and Jesus San Miguel Hospital Clinic, IDIBAPS, Barcelona, Spain Hospital de la Santa Creu i Sant Pau, Barcelona, Spain Hospital Universitario Germans Trias i Pujol, Barcelona, Spain Hospital Clinico, Madrid, Spain Hospital Ramon y Cajal, Madrid, Spain Hospital Clinico/ Centro de Investigacion del Cancer, Salamanca, Spain Hospital Clinico, Zaragoza, Spain Hospital Clinico, Valladolid, Spain Hospital Mutua de Terrassa, Terrassa, Spain Hospital Miguel Servet, Zaragoza, Spain Hospital General Universitario, Valencia, Spain Hospital Vall d'Hebron, Barcelona, Spain Hospital Carlos Haya, Malaga, Spain Hospital Dr. Josep Trueta, Girona, Spain Hematology, Hospital Virgen Blanca, Leon, Spain Hospital Nuestra Senora de Sonsoles, Avila, Spain Hematology, Hospital Parc Tauli, Sabadell, Spain Hospital Verge de la Cinta, Tortosa, Spain * Corresponding author; email: jblade{at}clinic.ub.es. The aim of the present randomized trial was to compare HDT versus continued conventional chemotherapy in patients with MM responding to the initial treatment. From May 1994 to October 1999, 216 patients (122M/94F, stage II or III, ECOG < 3) entered the study. The initial chemotherapy consisted of 4 cycles of alternating VBMCP/VBAD. Responding patients were randomized to receive either 8 additional cycles of VBMCP/VBAD or intensification with melphalan 200 mg/m2 or melphalan 140 mg/m2 plus 12 Gys of fractionated TBI. One-hundred and sixty four patients were randomized, 83 to continued chemotherapy and 81 to HDT. Complete remission was significantly higher with HDT (30 vs 11%, p=0.002). However, progression-free survival (PFS) was not significantly different between HDT and conventional therapy (median, 42 vs 33 months, p=NS) and the overall survival (OS) was similar in both groups (median, 61 vs 66 months). Finally, the survival after relapse was identical in the two arms (15.9 vs. 16.4 months). In conclusion, these results show that HDT intensification when given to myeloma patients who have responded to the initial chemotherapy significantly increases complete remission rate but has no significant impact on PFS and OS. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: To transplant or not to transplant? Nikhil C. Munshi and Kenneth C. Anderson Blood 2005 106: 3687-3688. [Full Text] [PDF] This article has been cited by other articles: J.-L. Harousseau, H. Avet-Loiseau, M. Attal, C. Charbonnel, F. Garban, C. Hulin, M. Michallet, T. Facon, L. Garderet, G. Marit, et al. Achievement of at Least Very Good Partial Response Is a Simple and Robust Prognostic Factor in Patients With Multiple Myeloma Treated With High-Dose Therapy: Long-Term Analysis of the IFM 99-02 and 99-04 Trials J. Clin. Oncol., December 1, 2009; 27(34): 5720 - 5726. [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] S. Kumar, S. Giralt, E. A. Stadtmauer, J. L. Harousseau, A. Palumbo, W. Bensinger, R. L. Comenzo, S. Lentzsch, N. Munshi, R. Niesvizky, et al. Mobilization in myeloma revisited: IMWG consensus perspectives on stem cell collection following initial therapy with thalidomide-, lenalidomide-, or bortezomib-containing regimens Blood, August 27, 2009; 114(9): 1729 - 1735. [Abstract] [Full Text] [PDF] J.-L. Harousseau and P. Moreau Autologous Hematopoietic Stem-Cell Transplantation for Multiple Myeloma N. Engl. J. Med., June 18, 2009; 360(25): 2645 - 2654. [Full Text] [PDF] A. A Saad, M. Sharma, and G. M Higa Treatment of Multiple Myeloma in the Targeted Therapy Era Ann. Pharmacother., February 1, 2009; 43(2): 329 - 338. [Abstract] [Full Text] [PDF] L. Rosinol, J. A. Perez-Simon, A. Sureda, J. de la Rubia, F. de Arriba, J. J. Lahuerta, J. D. Gonzalez, J. Diaz-Mediavilla, B. Hernandez, J. Garcia-Frade, et al. A prospective PETHEMA study of tandem autologous transplantation versus autograft followed by reduced-intensity conditioning allogeneic transplantation in newly diagnosed multiple myeloma Blood, November 1, 2008; 112(9): 3591 - 3593. [Abstract] [Full Text] [PDF] J. Mehta One or two autografts for myeloma? Blood, April 1, 2008; 111(7): 3899 - 3900. [Full Text] [PDF] R. A. Kyle and S. V. Rajkumar Multiple myeloma Blood, March 15, 2008; 111(6): 2962 - 2972. [Abstract] [Full Text] [PDF] S. K. Kumar, S. V. Rajkumar, A. Dispenzieri, M. Q. Lacy, S. R. Hayman, F. K. Buadi, S. R. Zeldenrust, D. Dingli, S. J. Russell, J. A. Lust, et al. Improved survival in multiple myeloma and the impact of novel therapies Blood, March 1, 2008; 111(5): 2516 - 2520. [Abstract] [Full Text] [PDF] W. 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Terol, et al. Bortezomib plus melphalan and prednisone in elderly untreated patients with multiple myeloma: results of a multicenter phase 1/2 study Blood, October 1, 2006; 108(7): 2165 - 2172. [Abstract] [Full Text] [PDF] F. Naumann, O. Weingart, E. Kruse, H. Schulz, J. Bohlius, H. Hulsewede, and A. Engert Fifth biannual report of the cochrane haematologic malignancies group--focus on multiple myeloma. J Natl Cancer Inst, August 16, 2006; 98(16): E2 - EE. [Full Text] 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]

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