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Blood, 1 April 2006, Vol. 107, No. 7, pp. 2633-2638. Prepublished online as a Blood First Edition Paper on December 1, 2005; DOI 10.1182/blood-2005-10-4084. This Article Full Text (PDF) All Versions of this Article: 2005-10-4084v1 107/7/2633    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 Barlogie, B. Articles by Crowley, J. Search for Related Content PubMed PubMed Citation Articles by Barlogie, B. Articles by Crowley, J. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted October 17, 2005 Accepted November 17, 2005 Total therapy 2 without thalidomide: comparison with total therapy 1: role of intensified induction and post-transplant consolidation therapies Bart Barlogie*, Guido Tricot, Erik Rasmussen, Elias Anaissie, Frits van Rhee, Maurizio Zangari, Athanasios Fassas, Klaus Hollmig, Mauricio Pineda-Roman, John Shaughnessy, Joshua Epstein, and John Crowley Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR, USA Cancer Research and Biostatistics, Seattle, WA, USA * Corresponding author; email: barlogiebart{at}uams.edu. Patients with myeloma, treated on the thalidomide arm of Total Therapy 2 (TT2), had a higher complete response (CR) and improved event-free survival (EFS) but not overall survival (OS). To evaluate the benefit of TT2's post-tandem autotransplant consolidation chemotherapy and dexamethasone maintenance, outcomes were compared on TT2 without thalidomide (n=345; median follow-up, 3.5yr) and on predecessor trial TT1 (n=231; median follow-up, 11.5yr). CR rates were similar (43% vs 41%); however, 5-yr estimates of continuous CR (45% vs 32%, p< 0.001) and 5-yr EFS (43% vs 28%, p< 0.001) were superior with TT2, with a trend for improved OS (62% vs 57%; p=0.11). OS was also superior among patients achieving CR and receiving the second transplant early after the first transplant. Superior EFS and OS with TT2 vs TT1 was noted in the two-thirds presenting without cytogenetic abnormalities (CA); 4-yr post-tandem transplant OS for patients with CA was 47% with TT1 and 76% with TT2 when combination chemotherapy rather than DEX was applied for consolidation (p=0.040). Thus, TT2 (without thalidomide) improved OS of patients without CA; those with CA benefited from post-transplant consolidation chemotherapy. The favorable effects of CR and rapidly-sequenced second transplant attest to the validity of a melphalan dose-response effect in myeloma. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: H. M. Lazarus, G. L. Phillips, R. H. Herzig, D. D. Hurd, S. N. Wolff, and G. P. Herzig High-Dose Melphalan and the Development of Hematopoietic Stem-Cell Transplantation: 25 Years Later J. Clin. Oncol., May 10, 2008; 26(14): 2240 - 2243. [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] J. Haessler, J. D. Shaughnessy Jr., F. Zhan, J. Crowley, J. Epstein, F. van Rhee, E. Anaissie, M. Pineda-Roman, M. Zangari, K. Hollmig, et al. 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