|
|
 Previous Article | Table of Contents | Next Article 
Blood, Vol. 92 No. 9 (November 1), 1998:
pp. 3131-3136
High-Dose Therapy and Autologous Peripheral Blood Stem Cell
Transplantation in Multiple Myeloma: Up-front or Rescue Treatment?
Results of a Multicenter Sequential Randomized Clinical Trial
Jean-Paul Fermand,
Philippe Ravaud,
Sylvie Chevret,
Marine Divine,
Véronique Leblond,
Coralie Belanger,
Margaret Macro,
Edouard Pertuiset,
François Dreyfus,
Xavier Mariette,
Catherine Boccacio, and
Jean-Claude Brouet for the Group "Myélome
Autogreffe"*
From the Immuno-Haematology Unit and the Department of Biostatistics,
Hôpital Saint Louis, Paris; The Rheumatology and Haematology
Units, Hôpital Cochin, Paris; the Haematology Unit, Hôpital
Henri Mondor, Creteil; the Haematology Unit and the Department of
Haemobiology, Hôpital Pitié-Salpétrière, Paris;
the Haematology Unit, Hôpital Necker, Paris; the Rheumatology
Unit, Hôpital Lariboisière, Paris; and the Haematology
Unit, Centre Hospitalier, Caen, France.
Results to date indicate that high-dose therapy (HDT) with
autologous stem cell support improves survival of patients with symptomatic multiple myeloma (MM). We performed a multicenter, sequential, randomized trial designed to assess the optimal timing of
HDT and autotransplantation. Among 202 enrolled patients who were up to
56 years old, 185 were randomly assigned to receive HDT and peripheral
blood stem cell (PBSC) autotransplantation (early HDT group, n = 91)
or a conventional-dose chemotherapy (CCT) regimen (late HDT group, n
= 94). In the late HDT group, HDT and transplantation were performed
as rescue treament, in case of primary resistance to CCT or at relapse
in responders. PBSC were collected before randomization, after
mobilization by chemotherapy, and, in the two groups, HDT was preceded
by three or four treatments with vincristine, doxorubicin, and
methylprednisolone. Data were analyzed on an
intent-to-treat basis using a sequential design. Within a median
follow-up of 58 months, estimated median overall survival (OS) was 64.6 months in the early HDT group and 64 months in the late group. Survival
curves were not different (P = .92, log-rank test). Median
event-free survival (EFS) was 39 months in the early HDT group whereas
median time between randomization and CCT failure was 13 months in the
late group. Average time without symptoms, treatment, and treatment
toxicity (TWiSTT) were 27.8 months (95% confidence interval [CI];
range, 23.8 to 31.8) and 22.3 months (range, 16.0 to 28.6)
in the two groups, respectively. HDT with PBSC transplantation obtained
a median OS exceeding 5 years in young patients with symptomatic MM,
whether performed early, as first-line therapy, or late, as rescue
treatment. Early HDT may be preferred because it is associated with a
shorter period of chemotherapy.
© 1998 by The American Society of Hematology.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
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. Kumar, M. A. Kharfan-Dabaja, A. Glasmacher, and B. Djulbegovic
Tandem Versus Single Autologous Hematopoietic Cell Transplantation for the Treatment of Multiple Myeloma: A Systematic Review and Meta-analysis
J Natl Cancer Inst,
January 21, 2009;
101(2):
100 - 106.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. V. Rajkumar
Treatment of Myeloma: Cure vs Control
Mayo Clin. Proc.,
October 1, 2008;
83(10):
1142 - 1145.
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Lunghi, N. Giuliani, L. Mazzera, G. Lombardi, M. Ricca, A. Corradi, A. M. Cantoni, L. Salvatore, R. Riccioni, A. Costanzo, et al.
Targeting MEK/MAPK signal transduction module potentiates ATO-induced apoptosis in multiple myeloma cells through multiple signaling pathways
Blood,
September 15, 2008;
112(6):
2450 - 2462.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Mehta
One or two autografts for myeloma?
Blood,
April 1, 2008;
111(7):
3899 - 3900.
[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]
|
|
|
|
|
|
|
A. Abdelkefi, S. Ladeb, L. Torjman, T. B. Othman, A. Lakhal, N. B. Romdhane, H. E. Omri, M. Elloumi, H. Belaaj, R. Jeddi, et al.
Single autologous stem-cell transplantation followed by maintenance therapy with thalidomide is superior to double autologous transplantation in multiple myeloma: results of a multicenter randomized clinical trial
Blood,
February 15, 2008;
111(4):
1805 - 1810.
[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]
|
|
|
|
|
|
|
S. V. Rajkumar and S. R. Hayman
Controversies Surrounding the Initial Treatment of Multiple Myeloma
ASCO Educational Book,
January 1, 2008;
2008(1):
369 - 374.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J.-P. Fermand
Initial Therapy for Multiple Myeloma: Role of Stem Cell Transplantation
ASCO Educational Book,
January 1, 2008;
2008(1):
375 - 379.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Dingli, J. M. Pacheco, G. S. Nowakowski, S. K. Kumar, A. Dispenzieri, S. R. Hayman, M. Q. Lacy, D. A. Gastineau, and M. A. Gertz
Relationship Between Depth of Response and Outcome in Multiple Myeloma
J. Clin. Oncol.,
November 1, 2007;
25(31):
4933 - 4937.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. A. Katzel, P. Hari, and D. H. Vesole
Multiple Myeloma: Charging Toward a Bright Future
CA Cancer J Clin,
September 1, 2007;
57(5):
301 - 318.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Sonneveld, B. van der Holt, C. M. Segeren, E. Vellenga, A. J. Croockewit, G. E.G. Verhoef, J. J. Cornelissen, M. R. Schaafsma, M. H.J. van Oers, P. W. Wijermans, et al.
Intermediate-dose melphalan compared with myeloablative treatment in multiple myeloma: long-term follow-up of the Dutch Cooperative Group HOVON 24 trial
Haematologica,
July 1, 2007;
92(7):
928 - 935.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Dispenzieri, S. V. Rajkumar, M. A. Gertz, M. Q. Lacy, R. A. Kyle, P. R. Greipp, T. E. Witzig, J. A. Lust, S. J. Russell, S. R. Hayman, et al.
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]
|
|
|
|
|
|
|
R. Fonseca
Strategies for Risk-Adapted Therapy in Myeloma
Hematology,
January 1, 2007;
2007(1):
304 - 310.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Attal, J.-L. Harousseau, S. Leyvraz, C. Doyen, C. Hulin, L. Benboubker, I. Y. Agha, J.-H. Bourhis, L. Garderet, B. Pegourie, et al.
Maintenance therapy with thalidomide improves survival in patients with multiple myeloma
Blood,
November 15, 2006;
108(10):
3289 - 3294.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Singhal and J. Mehta
Multiple Myeloma
Clin. J. Am. Soc. Nephrol.,
November 1, 2006;
1(6):
1322 - 1330.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Q. Lacy
Multiple Myeloma: New Options, New Challenges
Mayo Clin. Proc.,
July 1, 2006;
81(7):
877 - 879.
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Dingli, G. S. Nowakowski, A. Dispenzieri, M. Q. Lacy, S. R. Hayman, S. V. Rajkumar, P. R. Greipp, M. R. Litzow, D. A. Gastineau, T. E. Witzig, et al.
Flow cytometric detection of circulating myeloma cells before transplantation in patients with multiple myeloma: a simple risk stratification system
Blood,
April 15, 2006;
107(8):
3384 - 3388.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J.-P. Fermand, S. Katsahian, M. Divine, V. Leblond, F. Dreyfus, M. Macro, B. Arnulf, B. Royer, X. Mariette, E. Pertuiset, et al.
High-Dose Therapy and Autologous Blood Stem-Cell Transplantation Compared With Conventional Treatment in Myeloma Patients Aged 55 to 65 Years: Long-Term Results of a Randomized Control Trial From the Group Myelome-Autogreffe
J. Clin. Oncol.,
December 20, 2005;
23(36):
9227 - 9233.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
N. C. Munshi and K. C. Anderson
To transplant or not to transplant?
Blood,
December 1, 2005;
106(12):
3687 - 3688.
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. V. Rajkumar and R. A. Kyle
Multiple Myeloma: Diagnosis and Treatment
Mayo Clin. Proc.,
October 1, 2005;
80(10):
1371 - 1382.
[Abstract]
[PDF]
|
|
|
|
|
|
|
M. Hamasaki, T. Hideshima, P. Tassone, P. Neri, K. Ishitsuka, H. Yasui, N. Shiraishi, N. Raje, S. Kumar, D. H. Picker, et al.
Azaspirane (N-N-diethyl-8,8-dipropyl-2-azaspiro [4.5] decane-2-propanamine) inhibits human multiple myeloma cell growth in the bone marrow milieu in vitro and in vivo
Blood,
June 1, 2005;
105(11):
4470 - 4476.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. A. Kyle and S. V. Rajkumar
Multiple Myeloma
N. Engl. J. Med.,
October 28, 2004;
351(18):
1860 - 1873.
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Morris, S. Iacobelli, R. Brand, B. Bjorkstrand, M. Drake, D. Niederwieser, and G. Gahrton
Benefit and Timing of Second Transplantations in Multiple Myeloma: Clinical Findings and Methodological Limitations in a European Group for Blood and Marrow Transplantation Registry Study
J. Clin. Oncol.,
May 1, 2004;
22(9):
1674 - 1681.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. M. Evens, S. Prachand, B. Shi, M. Paniaqua, L. I. Gordon, and R. B. Gartenhaus
Imexon-Induced Apoptosis in Multiple Myeloma Tumor Cells Is Caspase-8 Dependent
Clin. Cancer Res.,
February 15, 2004;
10(4):
1481 - 1491.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Attal, J.-L. Harousseau, T. Facon, F. Guilhot, C. Doyen, J.-G. Fuzibet, M. Monconduit, C. Hulin, D. Caillot, R. Bouabdallah, et al.
Single versus Double Autologous Stem-Cell Transplantation for Multiple Myeloma
N. Engl. J. Med.,
December 25, 2003;
349(26):
2495 - 2502.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Hideshima, D. Chauhan, T. Hayashi, K. Podar, M. Akiyama, C. Mitsiades, N. MItsiades, B. Gong, L. Bonham, P. de Vries, et al.
Antitumor Activity of Lysophosphatidic Acid Acyltransferase-{beta} Inhibitors, a Novel Class of Agents, in Multiple Myeloma
Cancer Res.,
December 1, 2003;
63(23):
8428 - 8436.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Blade, D. H. Vesole, and M. Gertz
Transplantation for multiple myeloma: who, when, how often?
Blood,
November 15, 2003;
102(10):
3469 - 3477.
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. G. Maloney, A. J. Molina, F. Sahebi, K. E. Stockerl-Goldstein, B. M. Sandmaier, W. Bensinger, B. Storer, U. Hegenbart, G. Somlo, T. Chauncey, et al.
Allografting with nonmyeloablative conditioning following cytoreductive autografts for the treatment of patients with multiple myeloma
Blood,
November 1, 2003;
102(9):
3447 - 3454.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Singhal
Treatment of multiple myeloma
BMJ,
September 13, 2003;
327(7415):
575 - 576.
[Full Text]
[PDF]
|
|
|
|
|
|
|
C.-K. Lee, B. Barlogie, N. Munshi, M. Zangari, A. Fassas, J. Jacobson, F. van Rhee, M. Cottler-Fox, F. Muwalla, and G. Tricot
DTPACE: An Effective, Novel Combination Chemotherapy With Thalidomide for Previously Treated Patients With Myeloma
J. Clin. Oncol.,
July 15, 2003;
21(14):
2732 - 2739.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. A. Child, G. J. Morgan, F. E. Davies, R. G. Owen, S. E. Bell, K. Hawkins, J. Brown, M. T. Drayson, P. J. Selby, and the Medical Research Council Adult Leukaemia Worki
High-Dose Chemotherapy with Hematopoietic Stem-Cell Rescue for Multiple Myeloma
N. Engl. J. Med.,
May 8, 2003;
348(19):
1875 - 1883.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. M. Segeren, P. Sonneveld, B. van der Holt, E. Vellenga, A. J. Croockewit, G. E. G. Verhoef, J. J. Cornelissen, M. R. Schaafsma, M. H. J. van Oers, P. W. Wijermans, et al.
Overall and event-free survival are not improved by the use of myeloablative therapy following intensified chemotherapy in previously untreated patients with multiple myeloma: a prospective randomized phase 3 study
Blood,
March 15, 2003;
101(6):
2144 - 2151.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. V. Rajkumar, M. A. Gertz, R. A. Kyle, P. R. Greipp, and Mayo Clinic Myeloma, Amyloid, and Dysproteinemia G
Current Therapy for Multiple Myeloma
Mayo Clin. Proc.,
August 1, 2002;
77(8):
813 - 822.
[Abstract]
[PDF]
|
|
|
|
|
|
|
S. M. Devine, B. Jahagirdar, K. van Besien, P. Moreau, and J.-L. Harousseau
Reduced duration of cytopenias following melphalan conditioning and autografting for multiple myeloma
Blood,
May 13, 2002;
99(11):
4251 - 4252.
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Imrie, R. Esmail, R. M. Meyer, and and the Members of the Hematology Disease Site Gro
The Role of High-Dose Chemotherapy and Stem-Cell Transplantation in Patients with Multiple Myeloma: A Practice Guideline of the Cancer Care Ontario Practice Guidelines Initiative
Ann Intern Med,
April 16, 2002;
136(8):
619 - 629.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. C. Anderson, J. D. Shaughnessy Jr., B. Barlogie, J.-L. Harousseau, and G. D. Roodman
Multiple Myeloma
Hematology,
January 1, 2002;
2002(1):
214 - 240.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
A. A. Zaidi and D. H. Vesole
Multiple Myeloma: An Old Disease with New Hope for the Future
CA Cancer J Clin,
September 1, 2001;
51(5):
273 - 285.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. A. Kyle
Update on the Treatment of Multiple Myeloma
Oncologist,
April 1, 2001;
6(2):
119 - 124.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
N. C. Munshi
Arsenic Trioxide: An Emerging Therapy for Multiple Myeloma
Oncologist,
April 1, 2001;
6(90002):
17 - 21.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
W. S. Dalton, P. L. Bergsagel, W. M. Kuehl, K. C. Anderson, and J. L. Harousseau
Multiple Myeloma
Hematology,
January 1, 2001;
2001(1):
157 - 177.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. C. Anderson, R. A. Kyle, W. S. Dalton, T. Landowski, K. Shain, R. Jove, L. Hazlehurst, and J. Berenson
Multiple Myeloma: New Insights and Therapeutic Approaches
Hematology,
January 1, 2000;
2000(1):
147 - 165.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
