The efficacy of high-dose melphalan with autologous peripheral blood stem cell transplantation in patients with multiple myeloma.
Although high-dose therapy (HDT) with autologous hematopoietic stem cell transplantation (ASCT) is widely accepted as an effective and safe consolidation therapy for multiple myeloma (MM), few reports on its efficacy are available in Korea. We present the results of a prospective phase II study, involving 33 patients with MM treated with HDT with ASCT. The treatment consisted of 4 courses of VAD (vincristine, adriamycin, dexamethasone) induction, peripheral blood stem cell collection, and high-dose melphalan with stem cell infusion. The overall response rate was 93%, with 45% of patients having complete responses. The toxicity was predictable and tolerable. With a median follow-up of 27.6 months, the 2-year event free survival rate was 43%. At the time of writing, the median overall survival duration had not been reached with 2-year survival and projected 3-year survival rates of 81% and 74%, respectively. The overall survival was significantly better than that of the historical control patients (N=82) treated with conventional chemotherapy at our institution. The results suggest that HDT with ASCT is a valuable first or second-line treatment for patients with MM.
Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Jae-Lyun
JL
Lee
Sung-Bae
SB
Kim
Gyeong-Won
GW
Lee
Min-Hee
MH
Ryu
Eunkyoung
E
Kim
Shin
S
Kim
Woo-Kun
WK
Kim
Jung-Shin
JS
Lee
Sang-Hee
SH
Kim
Cheolwon
C
Suh
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008558:Melphalan / Q000627:therapeutic use*; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D009367:Neoplasm Staging; D036102:Peripheral Blood Stem Cell Transplantation; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate; D014182:Transplantation, Autologous
D008558:Melphalan