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Blood, 15 February 2006, Vol. 107, No. 4, pp. 1292-1298. Prepublished online as a Blood First Edition Paper on September 20, 2005; DOI 10.1182/blood-2005-04-1588. This Article Full Text (PDF) All Versions of this Article: 2005-04-1588v1 107/4/1292    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 Facon, T. Articles by Bataille, R. Search for Related Content PubMed PubMed Citation Articles by Facon, T. Articles by Bataille, R. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted April 19, 2005 Accepted July 13, 2005 Dexamethasone-based regimens versus melphalan-prednisone for elderly multiple myeloma patients ineligible for high-dose therapy Thierry Facon*, Jean-Yves Mary, Brigitte Pegourie, Michel Attal, Marc Renaud, Alain Sadoun, Laurent Voillat, Veronique Dorvaux, Cyrille Hulin, Gerard Lepeu, Jean-Luc Harousseau, Jean-Paul Eschard, Augustin Ferrant, Michel Blanc, Frederic Maloisel, Hubert Orfeuvre, Jean-Francois Rossi, Isabelle Azais, Mathieu Monconduit, Philippe Collet, Bruno Anglaret, Ibrahim Yakoub-Agha, Marc Wetterwald, Houchingue Eghbali, Marie-Christine Vekemans, Herve Maisonneuve, Jacques Troncy, Bernard Grosbois, Chantal Doyen, Antoine Thyss, Jerome Jaubert, Philippe Casassus, and Regis Bataille Service d'Hematologie, CHU, Lille, France Departemente de Biostatistique et Informatique Medicale, INSERM Erm0321,Hopital Saint-Louis,Universite Paris VII, Paris, France Service d'Hematologie, CHU, Grenoble, France Service d'Hematologie, CHU, Toulouse, France Hematologie et Rhumatologie, CHU, Poitiers, France CHU, Besancon, France CH, Metz, France CHU, Nancy, France CH, Avignon, France CHU, Nantes, France Service d'Rhumatologie, CHU, Reims, France Service d'Hematologie, UCL, Brussels, Belgium Service d'Hematologie, CH, Chambery, France CHU, Strasbourg, France CH, Bourg-en-Bresse, France CHU, Montpellier, France Service d'Hematologie, Centre Henri Becquerel, Rouen, France Service de Rhumatologie, CHU, Saint-Etienne, France Service d'Hematologie, CH, Valence, France CH, Saint-Brieuc, France CH, Dunkerque, France Service d'Hematologie, Institut Bergonie, Bordeaux, France Service de Medecine, CH, La Roche/Yon, France Service d'Hematologie, Hopital Edouard Herriot, Lyon, France Service de Medecine Interne, CHU, Rennes, France Service d'Hematologie, UCL, Yvoir, Belgium Service d'Hematologie, Centre Lacassagne, Nice, France CHU, Bobigny, France * Corresponding author; email: t-facon{at}chru-lille.fr. Dexamethasone alone increases life expectancy in patients with relapsed multiple myeloma (MM) ; however no large randomized study has compared dexamethasone and dexamethasone-based regimens with standard melphalan-prednisone in newly diagnosed MM patients, ineligible for high-dose therapy. In the IFM 95-01 trial, 488 patients, aged 65 to 75 years, were randomized between four regimens of treatment: melphalan-prednisone, dexamethasone alone, melphalan-dexamethasone and dexamethasone-interferon alpha. Response rates at 6 (except for complete response) were significantly higher among patients receiving melphalan-dexamethasone and progression-free survival was significantly better among patients receiving melphalan (P < .001, for both comparisons), but there was no difference in overall survival between the 4 treatment groups. Moreover, the morbidity associated with dexamethasone-based regimens was significantly higher than with melphalan-prednisone, especially for severe pyogenic infections in the melphalan-dexamethasone arm, and hemorrhage, severe diabetes, gastro intestinal and psychiatric complications in the dexamethasone arms. Overall, these results indicated that dexamethasone should not be routinely recommended as first-line treatment in elderly patients with MM. In the context of the IFM 95-01 trial, the standard melphalan-prednisone remained the best treatment choice, when efficacy and patient comfort were both considered. These results might be useful in the context of future combinations with innovative drugs. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: J. K Kettle, K. L Finkbiner, S. E Klenke, R. D Baker, D. W Henry, and C. B Williams Initial therapy in multiple myeloma: investigating the new treatment paradigm Journal of Oncology Pharmacy Practice, September 1, 2009; 15(3): 131 - 141. [Abstract] [PDF] C. Hulin, T. Facon, P. Rodon, B. Pegourie, L. Benboubker, C. Doyen, M. Dib, G. Guillerm, B. Salles, J.-P. Eschard, et al. Efficacy of Melphalan and Prednisone Plus Thalidomide in Patients Older Than 75 Years With Newly Diagnosed Multiple Myeloma: IFM 01/01 Trial J. Clin. Oncol., August 1, 2009; 27(22): 3664 - 3670. [Abstract] [Full Text] [PDF] P. G. Richardson, W. Xie, C. Mitsiades, A. A. Chanan-Khan, S. Lonial, H. Hassoun, D. E. Avigan, A. L. Oaklander, D. J. Kuter, P. Y. Wen, et al. Single-Agent Bortezomib in Previously Untreated Multiple Myeloma: Efficacy, Characterization of Peripheral Neuropathy, and Molecular Correlations With Response and Neuropathy J. Clin. Oncol., July 20, 2009; 27(21): 3518 - 3525. [Abstract] [Full Text] [PDF] H. Ludwig, R. Hajek, E. Tothova, J. Drach, Z. Adam, B. Labar, M. 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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] M.-V. Mateos, J. M. Hernandez, M. T. Hernandez, N. C. Gutierrez, L. Palomera, M. Fuertes, P. Garcia-Sanchez, J. J. Lahuerta, J. de la Rubia, M.-J. Terol, et al. Bortezomib plus melphalan and prednisone in elderly untreated patients with multiple myeloma: updated time-to-events results and prognostic factors for time to progression Haematologica, April 1, 2008; 93(4): 560 - 565. [Abstract] [Full Text] [PDF] W. Bensinger Stem-Cell Transplantation for Multiple Myeloma in the Era of Novel Drugs J. Clin. Oncol., January 20, 2008; 26(3): 480 - 492. [Abstract] [Full Text] [PDF] X. Mao, A. K. Stewart, R. Hurren, A. Datti, X. Zhu, Y. Zhu, C. Shi, K. Lee, R. Tiedemann, Y. Eberhard, et al. 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Treatment of Newly Diagnosed Multiple Myeloma Based on Mayo Stratification of Myeloma and Risk-Adapted Therapy (mSMART): Consensus Statement Mayo Clin. Proc., March 1, 2007; 82(3): 323 - 341. [Abstract] [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.-V. Mateos, J.-M. Hernandez, M.-T. Hernandez, N.-C. Gutierrez, L. Palomera, M. Fuertes, J. Diaz-Mediavilla, J.-J. Lahuerta, J. de la Rubia, M.-J. 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] R. Z. Orlowski Initial Therapy of Multiple Myeloma Patients Who Are Not Candidates for Stem Cell Transplantation Hematology, January 1, 2006; 2006(1): 338 - 347. [Abstract] [Full Text] [PDF]

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