High-Dose Therapy and Autologous Blood Stem-Cell Transplantation Compared With Conventional Treatment in Myeloma Patients Aged 55 to 65 Years: Long-Term Results of a Randomized Control Trial From the Group Myelome-Autogreffe

Abstract

With a median follow-up time of approximately 10 years, this randomized trial confirmed a benefit of HDT in terms of EFS and TwiSTT but did not provide evidence for superiority of HDT over CCT in OS of patients aged 55 to 65 years with symptomatic newly diagnosed MM.

Growth factor plus preemptive (‘just-in-time’) plerixafor successfully mobilizes hematopoietic stem cells in multiple myeloma patients despite prior lenalidomide exposure

“…29 High dose chemotherapy with AHSCT has become a standard treatment for younger and fit MM patients, as it is capable of providing sustained remission with improvement in both event-free survival [1][2][3]30 and overall survival. 1,2,30 The alkylating agent melphalan, a mainstay of MM therapy, has been shown to hamper stem cell collection and is avoided in the initial management of transplant-eligible patients.…”

“…[1][2][3] Over the last decade, novel drugs, particularly immunomodulatory (IMID) agents and proteasome inhibitors, have been incorporated into the pre-transplantation induction therapy and have improved the rate of complete response both before and after autologous transplantation. [4][5][6] The use of the IMID lenalidomide in the induction regimen was early identified as a risk factor for poor AHSC mobilization.…”

ESRD due to Multiple Myeloma in the United States, 2001–2010

“…1 In this regard, the therapeutic approach to earlier-stage multiple myeloma has changed substantially in recent decades. [2][3][4][5][6][7][8][9][10][11] However, the current belief is that even with aggressive therapy, the risk of progression to ESRD is high, recovery of renal function is low, and survival time on dialysis therapy is very short. 12 As the detection and treatment of multiple myeloma continues to evolve, it seems natural to question whether reductions in associated ESRD have occurred, and if so, among which demographic subgroups.…”

Outcome after autologous stem cell transplantation for multiple myeloma in patients with preceding plasma cell disorders

“…HDH and autologous SCT improves survival of these patients compared to conventional chemotherapy, however, it still fails to provide a cure. (Attal et al, 1996;Child et al, 2003;Fermand et al, 2005). Various factors that predict poor outcome after HDT have been identified and include the presence of cytogenetic abnormalities, such as deletion 13, presence of IGH translocations t(4;14) and t(14;16), high PCLI, elevated b 2 M, as well as failure to achieve a very good partial response or CR following HDT (Rajkumar & Greipp, 1999;Fonseca et al, 2004;Harousseau et al, 2006).…”

“…High dose therapy (HDT) and autologous stem cell transplantation (SCT) remains the standard of care for patients with myeloma who are eligible to undergo the procedure, having been shown to improve survival compared to conventional therapy (Attal et al, 1996;Child et al, 2003;Fermand et al, 2005). When performed early in the course of disease, HDT has been associated with median progression-free survival of 24-30 months and median overall survival (OS) of up to 4-5 years in different studies.…”