Superior 12-year survival after at least 4-year continuous remission with tandem transplantations for multiple myeloma.
Clin Lymphoma Myeloma
; 6(6): 469-74, 2006 May.
Article
em En
| MEDLINE
| ID: mdl-16796777
ABSTRACT
BACKGROUND:
Complete response has been considered a surrogate for favorable long-term outcome in multiple myeloma. Data on the impact of the duration of response on prognosis are lacking. PATIENTS ANDMETHODS:
Of the 899 patients enrolled in Total Therapy trials (Total Therapy 1, N = 231; Total Therapy 2, N = 668), 254 survived for > 5 years. The prognostic impact of continuous (Rc) versus discontinuous (Rd) 4-year remission after 5-year survival was examined along with laboratory features present at baseline and at 5 years.RESULTS:
Most baseline prognostic features were evenly distributed among Rc and Rd groups; however, a greater proportion of Rc patients were enrolled in Total Therapy 2 (60%) compared with Rd (19%; P < 0.001). Twelve-year survival (7 years after the 5-year landmark) was 66% with Rc and only 30% with Rd. Hypodiploidy and deletion 13, present in 24 patients at baseline, were associated with a 12-year survival of only 20%. Among the 200 patients lacking these cytogenetic abnormalities, Rc (n = 141) defined a superior 12-year survival rate of 70% versus 35% among those with Rd (n = 59). Initial quality of response (complete response) or having received the scheduled tandem transplantations did not affect post-5-year survival.CONCLUSION:
Five-year Rc appears to be an important prerequisite for prolonged subsequent overall survival.
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Base de dados:
MEDLINE
Assunto principal:
Protocolos de Quimioterapia Combinada Antineoplásica
/
Transplante de Células-Tronco Hematopoéticas
/
Mieloma Múltiplo
Idioma:
En
Ano de publicação:
2006
Tipo de documento:
Article