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Prognostic impact of early-versus-late responses to different induction regimens in patients with myeloma undergoing autologous hematopoietic cell transplantation: Results from the CALM study by the CMWP of the EBMT.
- Source :
-
European journal of haematology [Eur J Haematol] 2021 May; Vol. 106 (5), pp. 708-715. Date of Electronic Publication: 2021 Feb 27. - Publication Year :
- 2021
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Abstract
- Background: In autologous stem cell transplant (ASCT)-eligible myeloma patients, prolonged induction does not necessarily improve the depth of response.<br />Method: We analyzed 1222 ASCT patients who were classified based on (a) the interval between induction and stem cell collection, (b) the type of induction regimen: BID (Bortezomib, IMiDs, and Dexamethasone), Bortezomib-based, or CTD (Cyclophosphamide, Thalidomide, and Dexamethasone), and (c) the time to best response (Early ie, best response within 4 or 5 months, depending on the regimen vs Late; Good ie, VGPR or better vs Poor).<br />Results: The length of induction treatment required to achieve a Good response did not affect PFS (P = .65) or OS (P = .61) post-ASCT. The three types of regimen resulted in similar outcomes: median PFS 31, 27.7 and 30.8 months (P = .31), and median OS 81.7, 92.7, and 77.4 months, respectively (P = .83). On multivariate analysis, neither the type nor the duration of the induction regimen affected OS and PFS, except for Early Good Responders who had a better PFS compared to Early Poor Responders (HR = 1.21, P-value = .02). However, achieving a Good response at induction was associated with a better response (≥VGPR) post-transplant.<br />Conclusion: The kinetics of response did not affect outcomes.<br /> (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Subjects :
- Antineoplastic Combined Chemotherapy Protocols adverse effects
Duration of Therapy
Humans
Multiple Myeloma diagnosis
Multiple Myeloma mortality
Prognosis
Remission Induction
Time Factors
Transplantation, Autologous
Treatment Outcome
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Hematopoietic Stem Cell Transplantation adverse effects
Hematopoietic Stem Cell Transplantation methods
Multiple Myeloma therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1600-0609
- Volume :
- 106
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- European journal of haematology
- Publication Type :
- Academic Journal
- Accession number :
- 33580608
- Full Text :
- https://doi.org/10.1111/ejh.13602