1. Administration of bortezomib before and after autologous stem cell transplantation improves outcome in multiple myeloma patients with deletion l7p.
- Author
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Neben, Kai, Lokhorst, Henk M., Jauch, Anna, Bertsch, Uta, Hielscher, Thomas, van der Holt, Bronno, Salwender, Hans, Blau, Igor W., Weisel, Katja, Pfreundschuh, Michael, Scheid, Christof, Dührsen, Ulrich, Lindemann, Walter, Schmidt-Wolf, Ingo G. H., Peter, Norma, Teschendorf, Christian, Martin, Hans, Haenel, Mathias, Derigs, Hans G., and Raab, Marc S.
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AUTOTRANSPLANTATION , *STEM cell transplantation , *MULTIPLE myeloma treatment , *RANDOMIZED controlled trials , *CHROMOSOME abnormalities - Abstract
In patients with multiple myeloma (MM), risk stratification by chromosomal abnormalities may enable a more rational selection of therapeutic approaches. In the present study, we analyzed the prognostic value of 12 chromosomal abnormalities in a series of 354 MM patients treated within the HOVON-65/GMMG-HD4 trial. Because of the 2-arm design of the study, we were able to analyze the effect of a bortezomib-based treatment before and after autologous stem cell transplantation (arm B) compared with standard treatment without bortezomib (arm A). For all analyzed chromosomal aberrations, progression-free survival (PFS) and over- all survival (OS) were at least equal or superior in the bortezomib arm compared with the standard arm. Strikingly, patients with del(17p13) benefited the most from the bortezomib-containing treatment: the median PFS in arm A was 12.0 months and in arm B it was 26.2 months (P = .024); the 3 year-OS for arm A was 17% and for arm B it was 69% (P = .028). After multivariate analysis, del(17p13) was an independent predictor for PFS (P < .0001) and OS (P < .0001) in arm A, whereas no statistically significant effect on PFS(P = .28)or OS(P = .12) was seen in arm B. In conclusion, the adverse impact of del(17p13) on PFS and OS could be significantly reduced by bortezomib-based treatment, suggesting that long-term administration of bortezomib should be recommended for patients carrying del(17p13). This trial is registered at the International Standard Randomised Controlled Trial Number Register as ISRCTN64455289. (Blood. 2012;119(4): 940-948) [ABSTRACT FROM AUTHOR]
- Published
- 2012
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