Impact of additional cytoreduction following autologous SCT in multiple myeloma

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7 Citations (Scopus)

Abstract

Reported results of high-dose therapy (HDT) reflect the combined effect of initial therapy and HDT. The incremental contribution of HDT is often difficult to analyze with varying degrees of response pre-HDT. Here we analyze results of HDT in patients with measurable disease at transplant, defined as a serum or 24h urine M protein of >1.0g per 100ml and >200mg per day, respectively. Paraprotein responses were calculated using measurements prior to HDT and the lowest subsequent measurement. A total of 431 patients were studied; 264 (61.3%) transplanted within 1-year of diagnosis. An additional reduction in paraprotein by 50% following HDT was seen in 86% patients; with 129 patients (30%) obtaining a 90% reduction. Patients with at least a 90% reduction had longer time to progression with no overall survival advantage and this was independent of other prognostic factors for decreased risk of progression. This study provides an estimate of the degree of tumor reduction provided by HDT, in addition to that provided by the initial therapy. In this group of patients with measurable disease after initial therapy, HDT therapy leads to complete responses in nearly a quarter of the patients and a 90% reduction in another 7%, an outcome associated with better progression-free survival.

Original languageEnglish (US)
Pages (from-to)259-264
Number of pages6
JournalBone Marrow Transplantation
Volume42
Issue number4
DOIs
StatePublished - 2008

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Multiple Myeloma
Therapeutics
Paraproteins
Disease-Free Survival
Urine
Transplants

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

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title = "Impact of additional cytoreduction following autologous SCT in multiple myeloma",
abstract = "Reported results of high-dose therapy (HDT) reflect the combined effect of initial therapy and HDT. The incremental contribution of HDT is often difficult to analyze with varying degrees of response pre-HDT. Here we analyze results of HDT in patients with measurable disease at transplant, defined as a serum or 24h urine M protein of >1.0g per 100ml and >200mg per day, respectively. Paraprotein responses were calculated using measurements prior to HDT and the lowest subsequent measurement. A total of 431 patients were studied; 264 (61.3{\%}) transplanted within 1-year of diagnosis. An additional reduction in paraprotein by 50{\%} following HDT was seen in 86{\%} patients; with 129 patients (30{\%}) obtaining a 90{\%} reduction. Patients with at least a 90{\%} reduction had longer time to progression with no overall survival advantage and this was independent of other prognostic factors for decreased risk of progression. This study provides an estimate of the degree of tumor reduction provided by HDT, in addition to that provided by the initial therapy. In this group of patients with measurable disease after initial therapy, HDT therapy leads to complete responses in nearly a quarter of the patients and a 90{\%} reduction in another 7{\%}, an outcome associated with better progression-free survival.",
author = "Kumar, {Shaji K} and Dingli, {David M} and Angela Dispenzieri and Martha Lacy and Hayman, {S. R.} and Buadi, {F. K.} and Rajkumar, {S Vincent} and Litzow, {Mark R} and Morie Gertz",
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T1 - Impact of additional cytoreduction following autologous SCT in multiple myeloma

AU - Kumar, Shaji K

AU - Dingli, David M

AU - Dispenzieri, Angela

AU - Lacy, Martha

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AU - Buadi, F. K.

AU - Rajkumar, S Vincent

AU - Litzow, Mark R

AU - Gertz, Morie

PY - 2008

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N2 - Reported results of high-dose therapy (HDT) reflect the combined effect of initial therapy and HDT. The incremental contribution of HDT is often difficult to analyze with varying degrees of response pre-HDT. Here we analyze results of HDT in patients with measurable disease at transplant, defined as a serum or 24h urine M protein of >1.0g per 100ml and >200mg per day, respectively. Paraprotein responses were calculated using measurements prior to HDT and the lowest subsequent measurement. A total of 431 patients were studied; 264 (61.3%) transplanted within 1-year of diagnosis. An additional reduction in paraprotein by 50% following HDT was seen in 86% patients; with 129 patients (30%) obtaining a 90% reduction. Patients with at least a 90% reduction had longer time to progression with no overall survival advantage and this was independent of other prognostic factors for decreased risk of progression. This study provides an estimate of the degree of tumor reduction provided by HDT, in addition to that provided by the initial therapy. In this group of patients with measurable disease after initial therapy, HDT therapy leads to complete responses in nearly a quarter of the patients and a 90% reduction in another 7%, an outcome associated with better progression-free survival.

AB - Reported results of high-dose therapy (HDT) reflect the combined effect of initial therapy and HDT. The incremental contribution of HDT is often difficult to analyze with varying degrees of response pre-HDT. Here we analyze results of HDT in patients with measurable disease at transplant, defined as a serum or 24h urine M protein of >1.0g per 100ml and >200mg per day, respectively. Paraprotein responses were calculated using measurements prior to HDT and the lowest subsequent measurement. A total of 431 patients were studied; 264 (61.3%) transplanted within 1-year of diagnosis. An additional reduction in paraprotein by 50% following HDT was seen in 86% patients; with 129 patients (30%) obtaining a 90% reduction. Patients with at least a 90% reduction had longer time to progression with no overall survival advantage and this was independent of other prognostic factors for decreased risk of progression. This study provides an estimate of the degree of tumor reduction provided by HDT, in addition to that provided by the initial therapy. In this group of patients with measurable disease after initial therapy, HDT therapy leads to complete responses in nearly a quarter of the patients and a 90% reduction in another 7%, an outcome associated with better progression-free survival.

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