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| An elective single autograft with high-dose melphalan: single-center study of 451 patients |
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| Author(s): Sirohi B, Powles R, Mehta J, Rudin C, Kulkarni S, Horton C, Saso R, Singhal S, Treleaven J |
| Source: BONE MARROW TRANSPLANTATION Volume: 36 Issue: 1 Pages: 19-24 Published: JUL 2005 |
| Times Cited: 16 References: 25 |
| Abstract: In all, 451 myeloma patients, 51% previously untreated, underwent elective single autotransplantation after 200 mg/ m(2) melphalan between 1985 and 2001 at the Royal Marsden Hospital. The therapy sequence was: Induction ( vincristine, doxorubicin, methylprednisolone+/-cyclophosphamide), marrow or filgrastim- mobilized blood stem cell harvest, autograft, and interferon- alpha 2b maintenance. A total of 27 ( 6%) died of transplant- related toxicity, all within 3 months. Complete or near- complete remission was seen in 59% with an overall response rate of 91%. Subsequent disease progression was seen in 285, and 17 died of unrelated causes. In all, 206 patients were alive at the last follow- up, 6 months to 17.7 years posttransplant ( median 65 months); 122 without disease progression at 6 months to 17.7 years ( median 58 months). The median overall ( OS) and event- free ( EFS) survivals were 5.9 and 2.4 years, with 10- year OS and EFS probabilities of 31.4 and 16.5%, respectively. In Cox analysis, it was seen that significantly longer OS occurred for patients who had beta- 2- microglobulin < 3.5 mg/ l ( P < 0.0001), age < 60 years ( P = 0.001) and albumin >= 35 g/ l ( P = 0.009). EFS was also longer if beta-2-microglobulin was < 3.5 mg/ l ( P = 0.0056) and patients were < 60 years of age ( P = 0.033). We conclude that with a single planned autograft, patients with myeloma have an excellent outcome. |
| Document Type: Article |
| Language: English |
| Reprint Address: Sirohi, B (reprint author), Royal Marsden Hosp, Leukaemia Unit, Downs Rd, Sutton SM2 5PT, Surrey England |
Addresses:
1. Royal Marsden Hosp, Leukaemia Unit, Sutton SM2 5PT, Surrey England
2. Royal Marsden Hosp, Myeloma Unit, Sutton SM2 5PT, Surrey England
3. Inst Canc Res, Sutton, Surrey England |
| Publisher: NATURE PUBLISHING GROUP, MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND |
| Subject Category: Biophysics; Oncology; Hematology; Immunology; Transplantation |
| IDS Number: 937ID |
| ISSN: 0268-3369 |
| DOI: 10.1038/sj.bmt.1705000 |
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