Thalidomide as salvage therapy for VAD-refractory multiple myeloma prior to autologous PBSCT

Pitini, Vincenzo; Arrigo, Carmela; Aloi, G; Micali, Cristina; Gattuta, G La

doi:10.1038/sj.bmt.1704079

Cited by 2 publications

(2 citation statements)

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“…Within the HOVON-50 group, TAD patients reached a median CD34 þ yield of 7.4 Â 10 6 /kg cells (2.0-33.0) versus 9.4 Â 10 6 /kg (0.0-48.7; P ¼ 0.009) in VAD patients. In line with our results, Pitini et al 12 reported a significantly lower CD34 þ yield in PBSC collection after mobilization with cyclophosphamide and continuous administration of Thal, similar to the group of Zervas et al 13 For a single ABSCT 7% of VAD and 4% of TAD-treated patients (GMMG-HD3) and 5% of the patients within the VADand 3% within the TAD group (HOVON-50) were not able to reach sufficient CD34 þ yield. Moreover, 14% within both VAD and TAD groups (GMMG-HD3) and 13% of VAD as well as 18% of the patients treated with TAD did not reach sufficient CD34 þ cell yield for double ABSCT (data not shown).…”

Section: Pbsc Collectionsupporting

confidence: 80%

Thalidomide in newly diagnosed multiple myeloma: influence of thalidomide treatment on peripheral blood stem cell collection yield

et al. 2007

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In a phase III randomized, multicenter study, the Germanspeaking Myeloma-Multicenter Group (GMMG) and the DutchBelgian Hemato-Oncology Cooperative Group (HOVON) group investigated the influence of thalidomide (Thal) on the outcome of peripheral blood stem cell (PBSC) collection in multiple myeloma (MM) before peripheral autologous blood stem cell transplantation (ABSCT). We analyzed the data of 398 myeloma patients after induction with Thal, doxorubicin and dexamethasone (TAD) in comparison with vincristine, doxorubicin and dexamethasone (VAD) followed by mobilization with cyclophosphamide, doxorubicin, dexamethasone (CAD) and PBSC collection. Within both the study groups, patients treated with TAD showed to collect significantly fewer CD34 þ cells compared with VAD (GMMG, TAD: median 9.8 Â 10 6 /kg; range 2.0-33.6; VAD: median 10.9 Â 10 6 /kg range 3.0-36.0; P ¼ 0.02) (HOVON, TAD: median 7.4 Â 10 6 /kg; range 2.0-33.0; VAD: median 9.4 Â 10 6 /kg; range 0.0-48.7; P ¼ 0.009). However, engraftment after peripheral autologous stem cell transplantation showed no difference between Thal and VAD groups. We conclude that Thal as a part of induction regimen is associated with better response rates (GMMG-HD3: CR/PR 79%, VAD: CR/PR 58%; HOVON-50: TAD: CR/PR 81%, VAD: CR/PR 61%), but significantly affects the yield of PBSC collection. Nevertheless, the number of total CD34 þ cells collected was sufficient for double autologous transplantation in 82% of the Thal patients, with at least 2.5 Â 10 6 /kg CD34 þ cells.

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Section: Pbsc Collectionsupporting

confidence: 80%

Thalidomide in newly diagnosed multiple myeloma: influence of thalidomide treatment on peripheral blood stem cell collection yield

et al. 2007

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“…It has been confirmed by many study groups that THAL as a single agent (Dmoszynska et al, 2000;Patriarca et al, 2003) or combined with VAD (Ahmad et al, 2002;Pitini et al, 2003) could be a suitable bridging regimen to PBSC collection and autologous SCT for VAD-refractory MM patients. Moreover, Ghobrial et al (2003) showed that THAL does not substantionally affect peripheral blood mobilisation or engraftment, which is in line with our observation.…”

Section: Discussionmentioning

confidence: 95%

An evaluation of factors predicting long-term response to thalidomide in 234 patients with relapsed or resistant multiple myeloma

et al. 2004

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The aim of this study was to assess the prognostic value of pretreatment clinical and laboratory parameters in refractory or relapsed multiple myeloma (MM) patients who have a long-term response to thalidomide (THAL), lasting at least 18 months. The study was carried out on 234 patients who received THAL for relapsed/refractory myeloma. Out of the 234 patients, 129 patients (55.1%) responded to THAL with a mean response duration of 11.9 months (ranging from 1 to 48) and an overall survival rate of 20.3 months (ranging 1 -55 months). In 64 patients (27.4% of the whole group), the response to THAL lasted X18 months with a mean response lasting 24 months. Statistical analysis of the group of nonresponders and patients with long-term response to THAL showed a significantly higher serum albumin level (P ¼ 0.0003) and haemoglobin level (P ¼ 0.05), as well as a lower b2 microglobulin (b2M) (P ¼ 0.022), LDH (P ¼ 0.045) serum level in patients with long-term response. In this study, the LDH and serum albumin level were predictors for response to THAL therapy. The b2M serum level was not a predictor for response to THAL. The albumin serum level was the best parameter distinguishing the group of patients with long-term response to THAL from the entire responding group (P ¼ 0.02).

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Thalidomide as salvage therapy for VAD-refractory multiple myeloma prior to autologous PBSCT

Cited by 2 publications

References 4 publications

Thalidomide in newly diagnosed multiple myeloma: influence of thalidomide treatment on peripheral blood stem cell collection yield

Thalidomide in newly diagnosed multiple myeloma: influence of thalidomide treatment on peripheral blood stem cell collection yield

An evaluation of factors predicting long-term response to thalidomide in 234 patients with relapsed or resistant multiple myeloma

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