title: Total therapy-based treatment for multiple myeloma--a single center experience.
abstract: Incorporation of novel biological agents has become the cornerstone of treatment in multiple myeloma. For the last 4 years we have adopted the more intensified approach, previously published as total therapy 3 by the Arkansas group and used it with local modifications. This study aims to evaluate the efficacy and safety of the Arkansas protocol-based treatment outside clinical trial in a tertiary medical center in Israel. We retrospectively analyzed 23 patients. Seventy-three percent of the patients achieved very good partial remission (VGPR) before autologous stem cell transplantation (ASCT). Eighty-six percent of the patients achieved at least VGPR after tandem ASCT. Two-year overall survival was estimated as 70%. Four patients died during treatment, one as a result of disease progression. We conclude that this protocol is effective and rather safe. Further clinical trials should assess which subgroups of patients would benefit most from this approach.
authors.affiliation: Institute of Hematology, Davidoff Cancer Center, Beilinson Hospital, Petah-Tiqva, Israel.
authors.forename: Hila
authors.initials: H
authors.lastname: Magen-Nativ
authors.forename: Ron
authors.initials: R
authors.lastname: Ram
authors.forename: Moshe
authors.initials: M
authors.lastname: Yeshurun
authors.forename: Anat
authors.initials: A
authors.lastname: Gafter-Gvili
authors.forename: Pia
authors.initials: P
authors.lastname: Raanani
authors.forename: Ofer
authors.initials: O
authors.lastname: Shpilberg
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000627:therapeutic use; D003131:Combined Modality Therapy / Q000379:methods; D003520:Cyclophosphamide / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005047:Etoposide / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality* / Q000628:therapy*; D012189:Retrospective Studies; D033581:Stem Cell Transplantation / Q000401:mortality*; D015996:Survival Rate / Q000639:trends; D013792:Thalidomide / Q000627:therapeutic use; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D013792:Thalidomide; D005047:Etoposide; D003907:Dexamethasone; D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin