Maintenance versus Induction Therapy Choice on Outcomes after Autologous Transplantation for Multiple Myeloma

被引：19

作者：

Cornell, Robert F. ^{[1
]}

D'Souza, Anita ^{[2
]}

Kassim, Adetola A. ^{[1
]}

Costa, Luciano J. ^{[3
]}

Innis-Shelton, Racquel D. ^{[3
]}

Zhang, Mei-Jie ^{[2
,4
]}

Huang, Jiaxing ^{[2
]}

Abidi, Muneer ^{[5
]}

Aiello, Jack

Akpek, Gorgun ^{[6
]}

Bashey, Asad ^{[7
]}

Bashir, Qaiser ^{[8
]}

Cerny, Jan ^{[9
]}

Comenzo, Raymond ^{[10
]}

Angel Diaz, Miguel ^{[11
]}

Freytes, Cesar ^{[12
,13
]}

Gale, Robert Peter ^{[14
]}

Ganguly, Siddhartha ^{[15
]}

Hamadani, Mehdi ^{[2
]}

Hashmi, Shahrukh ^{[16
]}

Holmberg, Leona ^{[17
]}

Hossain, Nasheed ^{[18
]}

Kamble, Rammurti T. ^{[19
]}

Kharfan-Dabaja, Mohamed ^{[20
]}

Kindwall-Keller, Tamila ^{[21
]}

Kyle, Robert ^{[16
]}

Kumar, Shaji ^{[16
]}

Lazarus, Hillard ^{[22
]}

Lee, Cindy ^{[23
]}

Maiolino, Angelo ^{[24
]}

Marks, David I. ^{[25
]}

Meehan, Kenneth ^{[26
]}

Mikhael, Joe ^{[27
,28
]}

Nath, Rajneesh ^{[9
]}

Nishihori, Taiga ^{[20
]}

Olsson, Richard F. ^{[29
,30
]}

Ramanathan, Muthalagu ^{[9
]}

Saad, Ayman ^{[3
]}

Seo, Sachiko ^{[31
]}

Usmani, Saad ^{[32
]}

Vesole, David ^{[33
]}

Vij, Ravi ^{[34
]}

Vogl, Dan ^{[35
]}

Wirk, Baldeep M. ^{[36
]}

Yared, Jean ^{[37
]}

Krishnan, Amrita ^{[38
]}

Mark, Tomer ^{[39
]}

Nieto, Yago ^{[8
]}

Hari, Parameswaran ^{[2
]}

机构：

[1] Vanderbilt Univ, Med Ctr, Dept Med, Div Hematol Oncol, Nashville, TN USA

[2] Med Coll Wisconsin, Dept Med, CIBMTR, Milwaukee, WI 53226 USA

[3] Univ Alabama Birmingham, Dept Med, Div Hematol Oncol, Birmingham, AL 35294 USA

[4] Med Coll Wisconsin, Div Biostat, Inst Hlth & Soc, Milwaukee, WI 53226 USA

[5] Wayne State Univ, Dept Oncol, Karmanos Canc Inst, Div BMT, Detroit, MI USA

[6] Rush Univ, Med Ctr, Dept Internal Med, Stem Cell Transplantat & Cell Therapy, Chicago, IL 60612 USA

[7] Northside Hosp, Blood & Marrow Transplant Program, Atlanta, GA USA

[8] Univ Texas MD Anderson Canc Ctr, Div Canc Med, Dept Stem Cell Transplantat, Houston, TX 77030 USA

[9] UMass Mem Med Ctr, Dept Med, Div Hematol & Oncol, Worcester, MA USA

[10] Tufts Med Ctr, Boston, MA USA

[11] Hosp Infantil Univ Nino Jesus, Dept Hematol Oncol, Madrid, Spain

[12] South Texas Vet Hlth Care Syst, San Antonio, TX USA

[13] Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA

[14] Imperial Coll London, Dept Med, Div Expt Med, Hematol Res Ctr, London, England

[15] Univ Kansas, Med Ctr, Div Hematol & Oncol, Blood & Marrow Transplantat, Kansas City, KS 66103 USA

[16] Mayo Clin Rochester, Rochester, MN USA

[17] Fred Hutchinson Canc Res Ctr, 1124 Columbia St, Seattle, WA 98104 USA

[18] Fox Chase Canc Ctr, 7701 Burholme Ave, Philadelphia, PA 19111 USA

[19] Baylor Coll Med, Div Hematol & Oncol, Ctr Cell & Gene Therapy, Houston, TX 77030 USA

[20] H Lee Moffitt Canc Ctr & Res Inst, Dept Blood & Marrow Transplantat, Tampa, FL USA

[21] Univ Virginia Hlth Syst, Div Hematol Oncol, Charlottesville, VA USA

[22] Univ Hosp, Case Med Ctr, Seidman Canc Ctr, Cleveland, OH USA

[23] Royal Adelaide Hosp, Adelaide, SA, Australia

[24] Univ Fed Rio de Janeiro, Hosp Univ Clementinio Fraga Filho, Rio De Janeiro, Brazil

[25] Univ Hosp Bristol NHS Trust, Adult Bone Marrow Transplant, Bristol, Avon, England

[26] Dartmouth Hitchcock Med Ctr, Lebanon, NH 03766 USA

[27] Mayo Clin Arizona, Phoenix, AZ USA

[28] Phoenix Childrens Hosp, Phoenix, AZ USA

[29] Karolinska Inst, Dept Lab Med, Div Therapeut Immunol, Stockholm, Sweden

[30] Uppsala Univ, Ctr Clin Res Sormland, Uppsala, Sweden

[31] East Hosp, Natl Canc Res Ctr, Chiba, Japan

[32] Carolinas HealthCare Syst, Levine Canc Inst, Dept Med Hematol Oncol, Charlotte, NC USA

[33] John Theurer Canc Ctr Hackensack UMC, Hackensack, NJ USA

[34] Washington Univ, Sch Med, Div Hematol & Oncol, St Louis, MO USA

[35] Univ Penn, Abramson Canc Ctr, Philadelphia, PA 19104 USA

[36] Seattle Canc Care Alliance, Div Bone Marrow Transplant, Seattle, WA USA

[37] Univ Maryland, Dept Med, Div Hematol Oncol,Greenebaum Canc Ctr, Blood & Marrow Transplantat Program, Baltimore, MD 21201 USA

[38] City Hope Natl Med Ctr, 1500 E Duarte Rd, Duarte, CA 91010 USA

[39] Weill Cornell Med Coll, Dept Med, New York, NY USA

来源：

BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION | 2017年 / 23卷 / 02期

关键词：

Myeloma; Transplantation; Survival; Relapse; Chemotherapy; Maintenance; STEM-CELL TRANSPLANTATION; THALIDOMIDE PLUS DEXAMETHASONE; CONSOLIDATION THERAPY; RANDOMIZED PHASE-3; SURVIVAL; BORTEZOMIB; LENALIDOMIDE; TRIAL; ABNORMALITIES; HYBRIDIZATION;

D O I：

10.1016/j.bbmt.2016.11.011

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Bortezomib (V), lenalidomide (R), cyclophosphamide (C), and dexamethasone (D) are components of the most commonly used modern doublet (RD, VD) or triplet (VRD, CVD) initial induction regimens before autologous hematopoietic cell transplantation (AHCT) for multiple myeloma (MM) in the United States. In this study we evaluated 693 patients receiving "upfront" AHCT after initial induction therapy with modern doublet or triplet regimens using data reported to the Center for International Blood and Marrow Transplant Research from 2008 to 2013. Analysis was limited to those receiving a single AHCT after 1 line of induction therapy within 12 months from treatment initiation for MM. In multivariate analysis, progression-free survival (PFS) and overall survival were similar irrespective of induction regimen. However, high-risk cytogenetics and nonreceipt of post transplant maintenance/consolidation therapy were associated with higher risk of relapse. Patients receiving post-transplant therapy had significantly improved 3-year PFS versus no post-transplant therapy (55% versus 39%, P =.0001). This benefit was most evident in patients not achieving at least a complete response post-AHCT (P =.005). In patients receiving upfront AHCT, the choice of induction regimen (doublet or triplet therapies) appears to be of lower impact than use of post-transplant therapy. (C) 2017 American Society for Blood and Marrow Transplantation.

引用

页码：269 / 277

页数：9

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