High-dose chemotherapy followed by autologous stem cell transplantation changes prognosis of IgD multiple myeloma

被引:19
作者
Maisnar, V. [1 ]
Hajek, R. [2 ]
Scudla, V. [3 ]
Gregora, E. [4 ]
Buchler, T. [2 ]
Tichy, M. [5 ]
Kotoucek, P. [6 ]
Kafkova, A. [7 ]
Forraiova, L. [8 ]
Minarik, J. [3 ]
Radocha, J. [1 ]
Blaha, V. [9 ]
Maly, J. [1 ]
机构
[1] Charles Univ Prague, Fac Hosp,Div Clin Hematol, Dept Clin Hematol, Dept Internal Med 2, Hradec Kralove 50005, Czech Republic
[2] TG Masaryk Univ Hosp, Dept Internal Med Hematooncol, Brno, Czech Republic
[3] F Palacky Univ Hosp, Dept Med 3, Olomouc, Czech Republic
[4] Charles Univ Hosp Kralovske Vinohardy, Dept Clin Hematol, Prague, Czech Republic
[5] Charles Univ Hosp, Inst Clin Biochem & Diagnost, Hradec Kralove, Czech Republic
[6] JA Komensky Univ Hosp, Dept Hematol & Transfus Med, Bratislava, Slovakia
[7] L Pasteur Univ Hosp, Dept Hematol & Oncohematol, Kosice, Slovakia
[8] JA Reiman Mem Hosp, Dept Hematol, Presov, Czech Republic
[9] Fac Mil Hlth Sci, Dept Multidisciplinary Sci, Hradec Kralove, Czech Republic
关键词
IgD; multiple myeloma; prognosis; therapy; autologous transplantation;
D O I
10.1038/sj.bmt.1705881
中图分类号
Q6 [生物物理学];
学科分类号
071011 ;
摘要
Immunoglobulin D (IgD) multiple myeloma (MM) is a rare plasma cell disorder constituting less than 2% of all MM cases. Survival of patients with IgD MM is generally shorter than that of patients with other types of monoclonal (M-) protein. We have retrospectively analyzed patients with IgD MM participating in clinical trials of the Czech Myeloma Group. Twenty-six IgD MM patients treated between 1996 and 2006 were identified, 14 (54%) men and 12 (46%) women. The median age was 61 years (range: 37-79 years). Ten of 26 patients (39%) were treated with first-line high-dose chemotherapy (HDCT) using melphalan 200 mg/m(2) followed by autologous stem cell transplantation (ASCT). Thirteen of 26 patients (50%) received conventional chemotherapy (CHT), mostly melphalan and prednisone or a vincristine/doxorubicin/dexamethasone (VAD) regimen. Treatment responses were evaluable for 23 of 26 (89%) patients. All HDCT patients had treatment responses, including seven patients (70%) with complete responses and three patients (30%) with partial responses. The median progression-free survival was 18 months for HDCT patients and 20 months for CHT patients. The median overall survival (OS) for all patients was 34 months. The median OS for the HDCT group has not yet been reached (70% of the patients are still alive). In contrast, the median OS for CHT patients was only 16 months. The difference in OS between the two groups was statistically significant (P = 0.005). In conclusion, the overall response rate for patients with IgD MM aged 65 years or less treated with HDCT and ASCT is similar to that seen in other MM types.
引用
收藏
页码:51 / 54
页数:4
相关论文
共 27 条
  • [1] Albarede S, 2005, ANN BIOL CLIN-PARIS, V63, P107
  • [2] A prospective, randomized trial of autologous bone marrow transplantation and chemotherapy in multiple myeloma
    Attal, M
    Harousseau, JL
    Stoppa, AM
    Sotto, JJ
    Fuzibet, JG
    Rossi, JF
    Casassus, P
    Maisonneuve, H
    Facon, T
    Ifrah, N
    Payen, C
    Bataille, R
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1996, 335 (02) : 91 - 97
  • [3] High-dose therapy and innovative approaches to treatment of multiple myeloma
    Barlogie, B
    [J]. SEMINARS IN HEMATOLOGY, 2001, 38 (02) : 21 - 27
  • [4] Long-term outcome results of the first tandem autotransplant trial for multiple myeloma
    Barlogie, Bart
    Tricot, Guido J.
    van Rhee, Frits
    Angtuaco, Edguardo
    Walker, Ron
    Epstein, Joshua
    Shaughnessy, John D.
    Jagannath, Sundar
    Bolejack, Vanessa
    Gurley, Jennifer
    Hoering, Antje
    Vesole, David
    Desikan, Raman
    Siegel, David
    Mehta, Jayesh
    Singhal, Seema
    Munshi, Nikhil C.
    Dhodapkar, Madhav
    Jenkins, Bonnie
    Attal, Michel
    Harousseau, Jean-Luc
    Crowley, John
    [J]. BRITISH JOURNAL OF HAEMATOLOGY, 2006, 135 (02) : 158 - 164
  • [5] Long-term complete remission in IgD-myeloma
    Bemelmans, RHH
    van Toorn, DW
    van Leeuwen, L
    Schaar, CG
    [J]. EUROPEAN JOURNAL OF HAEMATOLOGY, 2006, 76 (04) : 339 - 341
  • [6] IMMUNOGLOBULIN-D MULTIPLE-MYELOMA - PRESENTING FEATURES, RESPONSE TO THERAPY, AND SURVIVAL IN A SERIES OF 53 CASES
    BLADE, J
    LUST, JA
    KYLE, RA
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 1994, 12 (11) : 2398 - 2404
  • [7] Nonsecretory myeloma, immunoglobulin D myeloma, and plasma cell leukemia
    Bladé, J
    Kyle, RA
    [J]. HEMATOLOGY-ONCOLOGY CLINICS OF NORTH AMERICA, 1999, 13 (06) : 1259 - +
  • [8] IGD MONOCLONAL GAMMOPATHY WITH LONG-TERM FOLLOW-UP
    BLADE, J
    KYLE, RA
    [J]. BRITISH JOURNAL OF HAEMATOLOGY, 1994, 88 (02) : 395 - 396
  • [9] Blade Joan, 1998, British Journal of Haematology, V102, P1115, DOI 10.1046/j.1365-2141.1998.00930.x
  • [10] International uniform response criteria for multiple myeloma
    Durie, B. G. M.
    Harousseau, J-L
    Miguel, J. S.
    Blade, J.
    Barlogie, B.
    Anderson, K.
    Gertz, M.
    Dimopoulos, M.
    Westin, J.
    Sonneveld, P.
    Ludwig, H.
    Gahrton, G.
    Beksac, M.
    Crowley, J.
    Belch, A.
    Boccadaro, M.
    Turesson, I.
    Joshua, D.
    Vesole, D.
    Kyle, R.
    Alexanian, R.
    Tricot, G.
    Attal, M.
    Merlini, G.
    Powles, R.
    Richardson, P.
    Shimizu, K.
    Tosi, P.
    Morgan, G.
    Rajkumar, S. V.
    [J]. LEUKEMIA, 2006, 20 (09) : 1467 - 1473