High dose therapy followed by autologous peripheral blood stem cell transplantation as a first line treatment for multiple myeloma: a Korean Multicenter Study.
We conducted a phase II multicenter trial to estimate the response and survival of patients with newly diagnosed multiple myeloma to high dose melphalan therapy followed by autologous peripheral blood stem cell transplantation. Eligible patients who had undergone induction with vincristine, adriamycin and dexamethasone (VAD) should have adequate cardiac, pulmonary and renal function (creatinine <2 mg/dL). Melphalan at 200 mg/m2 was used as a conditioning regimen. Eighty patients were enrolled from 13 centers. The median age of the patients was 53 yr (range; 20 to 68 yr). The initial stage was IA/IIA/IIB/IIIA/IIIB in 3/8/1/54/14 patients, respectively. Beta2-microglobulin, CRP and LDH were increased in 74, 42 and 34% of the patients examined. Cytogenetic data were available in 30 patients, and 6 patients showed numeric or structural abnormalities. Two therapy-related mortalities occurred from infection. Among the 78 evaluable patients, CR/PR/MR/NC/PD were achieved in 48/26/2/1/1 patients, respectively. After a median follow-up of 30 months, the median overall and event-free survivals were 66 months (95% CI: 20-112) and 24 months (95% CI: 18-29), respectively. This study verifies the efficacy and feasibility of high dose melphalan therapy with autologous stem cell transplantation in newly diagnosed multiple myeloma.
Bang
Soo-Mee
SM
Department of Internal Medicine, Gachon Medical School, University of Ulsan Medical School, Incheon, Korea. smbang@hanmail.net
Cho
Eun Kyung
EK
Suh
Cheolwon
C
Yoon
Sung-Soo
SS
Seong
Chu Myung
CM
Cho
Kyung Sam
KS
Kang
Yoon Goo
YG
Park
Seonyang
S
Ahn
Myung-Ju
MJ
Park
Young Suk
YS
Oh
Doyeun
D
Kim
Hugh C
HC
Jung
Chul Won
CW
Kim
Samyong
S
Lee
Jae Hoon
JH
D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000096:biosynthesis; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use*; D002097:C-Reactive Protein / Q000096:biosynthesis; D002470:Cell Survival; D003131:Combined Modality Therapy; D003582:Cytogenetics; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007723:Korea; D007770:L-Lactate Dehydrogenase / Q000096:biosynthesis; D008297:Male; D008558:Melphalan / Q000627:therapeutic use*; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods*; D013997:Time Factors; D014182:Transplantation, Autologous / Q000379:methods*; D001613:beta 2-Microglobulin / Q000097:blood
D018952:Antigens, CD34; D018906:Antineoplastic Agents, Alkylating; D001613:beta 2-Microglobulin; D002097:C-Reactive Protein; D007770:L-Lactate Dehydrogenase; D008558:Melphalan