title: [Response and prognosis of patients with multiple myeloma induced by PAD/TAD].
abstract: OBJECTIVE
  To evaluate the impact of cytogenetic grouping and autologous stem cell transplantation on the prognosis of patients with multiple myeloma (MM) induced by PAD (velcade+epirubicin+dexamethasone) and TAD (thalidomide+epirubicin+dexamethasone).
  
  
  METHODS
  A total of 191 patients with a definite diagnosis of MM were enrolled from May 2008 to December 2013 into this prospective study. They were non-randomly induced by PAD (n = 132) or TAD (n = 59) plus autologous stem cell transplantation or chemotherapy. Response and survival rates were also analyzed between two groups.
  
  
  RESULTS
  The overall response rates of PAD and TAD groups were 84.4% (108/128) and 69.5% (41/59) (P = 0.011) respectively. The very good partial remission (VGPR) rates were 70.3% (90/128) and 32.2% (19/59) (P < 0.001) and near complete remission/complete remission (nCR/CR) rates 68.0% (87/128) and 25.4% (15/59) respectively (P < 0.001). Both progression-free survival (PFS) and overall survival (OS) showed no significant inter-group difference (P = 0.223, 0.989). The survival analysis of PAD group showed that FISH high-risk group had shorter PFS and OS than FISH low-risk group (15.2 vs 19.1 months for PFS, P = 0.098; 41.2 months vs non-attaining for OS, P = 0.017). In FISH high-risk group, patients consolidated with autologous stem cell transplantation showed longer PFS than those with chemotherapy (17.8 vs 14.6 months, P = 0.029) while the OS showed no difference (P = 0.840). In FISH low-risk group, no difference were observed in PFS and OS between patients with consolidation therapies alone (P = 0.131, 0.294).
  
  
  CONCLUSIONS
  The response rates are higher in patients induced by PAD than by TAD. After PAD induction, cytogenetic grouping may further distinguish the prognosis of MM patients. For FISH high-risk patients, their PFS is prolonged by autologous stem cell transplantation.
authors.affiliation: Department of Hematology, Myeloma and Lymphoma Center, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Tianmei
authors.initials: T
authors.lastname: Zeng
authors.forename: Haiyan
authors.initials: H
authors.lastname: He
authors.forename: Haotian
authors.initials: H
authors.lastname: Shi
authors.forename: Hao
authors.initials: H
authors.lastname: Xi
authors.forename: Juan
authors.initials: J
authors.lastname: Du
authors.forename: Chunyang
authors.initials: C
authors.lastname: Zhang
authors.forename: Hua
authors.initials: H
authors.lastname: Jiang
authors.forename: Weijun
authors.initials: W
authors.lastname: Fu
authors.forename: Fan
authors.initials: F
authors.lastname: Zhou
authors.affiliation: Email: houjian@medmail.com.cn.
authors.forename: Jian
authors.initials: J
authors.lastname: Hou
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols; D018572:Disease-Free Survival; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D009101:Multiple Myeloma; D011379:Prognosis; D011446:Prospective Studies; D012074:Remission Induction; D015996:Survival Rate; D014182:Transplantation, Autologous