Intensive therapy in multiple myeloma.
During the past 10 years, high-dose therapy (HDT) has been widely explored in multiple myeloma. The first randomized study comparing conventional chemotherapy and HDT followed by autologous bone marrow transplantation has been completed by the Intergroupe Français du Myelome. This trial designed for patients under 65 years of age with newly diagnosed myeloma has shown that HDT is superior to CC in terms of response rate, event free survival and survival. However a number of issues remain to be addressed regarding autologous transplantation: feasibility and survival impact in patients over 60 years of age, conditioning regimen, source of stem cells, impact of tandem transplants, maintenance therapy. The place of allogeneic bone marrow transplantation in the management of younger patients remains controversial due to a high toxic death rate.
Harousseau
J L
JL
Service d'Hématologie, Hôtel-Dieu, CHU, Nantes, France.
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D006801:Humans; D009101:Multiple Myeloma / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous
D000970:Antineoplastic Agents