Back to Search
Start Over
Full or intensity-reduced high-dose melphalan and single or double autologous stem cell transplant with or without bortezomib consolidation in patients with newly diagnosed multiple myeloma
- Source :
- European journal of haematologyREFERENCE. 107(5)
- Publication Year :
- 2021
-
Abstract
- OBJECTIVE A post hoc subgroup analysis of two phase III trials (NCT00416273, NCT00416208) was carried out to investigate the influence of 100/140 and 200 mg/m² melphalan as well as single/double autologous stem cell transplantation (ASCT) on progression-free survival (PFS). Additionally, the effect of bortezomib consolidation on PFS was analyzed. METHODS Following induction therapy and high-dose melphalan with subsequent ASCT, patients with newly diagnosed multiple myeloma (NDMM) were randomized 1:1 to either four 35-day cycles of bortezomib consolidation (1.6 mg/m² IV on days 1, 8, 15, 22) or observation. RESULTS Of the 340 patients included in this analysis, 13.5% received 1 × MEL100/140, 22.9% 2 × MEL100/140, 31.2% 1 × MEL200, and 32.4% 2 × MEL200. With higher cumulative melphalan dose, PFS improved (P = .0085). PFS curves of patients treated with 2 × MEL100/140 and 1 × MEL200 were very similar. The superior dose effect of MEL200 over MEL100/140 was non-existent in the bortezomib consolidation arm but pronounced in the observation arm (P = .0015). Similarly, double ASCT was only beneficial in patients without bortezomib consolidation (P = .0569). CONCLUSIONS Full dose melphalan and double transplantation seem advantageous only as long as patients are not receiving bortezomib consolidation afterwards.
- Subjects :
- Melphalan
Oncology
Male
medicine.medical_specialty
Subgroup analysis
Transplantation, Autologous
Bortezomib
03 medical and health sciences
0302 clinical medicine
Autologous stem-cell transplantation
hemic and lymphatic diseases
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
Medicine
Humans
neoplasms
Multiple myeloma
Aged
Retrospective Studies
Dose-Response Relationship, Drug
business.industry
Hematopoietic Stem Cell Transplantation
Hematology
General Medicine
Middle Aged
medicine.disease
Combined Modality Therapy
Intensity (physics)
Transplantation
Consolidation Chemotherapy
030220 oncology & carcinogenesis
Female
Stem cell
business
Multiple Myeloma
030215 immunology
medicine.drug
Subjects
Details
- ISSN :
- 16000609
- Volume :
- 107
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- European journal of haematologyREFERENCE
- Accession number :
- edsair.doi.dedup.....e8752cd0c14279cbff75d147fea921ff