title: [Efficacy and prognostic factors of induction therapy combined with autologous stem cell transplantation in 201 patients with multiple myeloma].
abstract: OBJECTIVE
  To explore the efficacy and prognostic factors of induction therapy combined with autogenetic peripheral blood stem cells transplantation (APBSCT)in patients with multiple myeloma (MM).
  
  
  METHODS
  From January 1998 to May 2015, 201 patients with MM were enrolled. All patients received APBSCT after induction therapy. With the follow up to 20 June 2015, the overall survival (OS), progression free survival (PFS)and prognostic factor were analyzed.
  
  
  RESULTS
  ① With a media follow up of 36.67 months, the median PFS and OS were 22.87 (17.48- 28.26)and 69.63 (63.57- 75.69)months, 5-year PFS and OS were 17% and 49%, respectively. ②After APBSCT, when the subgroup (n= 112) achieved complete response (CR)compared with the subgroup (n=89) not achieved CR, the median PFS were 32.93 (21.03-44.83) and 18.13 (14.46-21.80) months (P<0.001), respectively; And the media OS were 96.77 (71.79- 121.75)and 54.70 (49.53- 59.87) months (P=0.004), respectively. The risks for disease progression and death declined in CR subgroup. ③ Two subgroups included or not included bortezomib/thalidomide at induction therapy (123 patientsvs 21 patients), the media PFS were 31.67 (24.36- 38.98)and 15.20 (10.11- 20.29) months (P=0.013), respectively; And the media OS were 76.30 (55.44- 97.15)and 52.03 (33.76- 70.30) months (P=0.014), respectively. ④According to the ISS stage, the media OS of stageⅠ, Ⅱ, Ⅲ were 99.47 (59.58-139.36), 66.77 (52.17-81.37), 53.97 (28.71-79.23) (P< 0.001), respectively. The risk for death of stage Ⅱ, Ⅲ were 2.16 and 3.04 times higher than stage Ⅰ, with no difference in terms of PFS. ⑤ The media PFS in IgD (n=22) and IgG (n=101) type MM were 11.17 (10.27- 13.13)and 35.43 (22.69- 48.17)months (P=0.007) , respectively; The media OS were 30.83 (0.24-61.42)and 70.70 (53.52-87.88) months (P=0.039), respectively. The risk for disease progression of IgD type was 2.47 times higher than IgG type. ⑥ Patients received 1 line induction therapy (n=132) compared with more than 1 line (n=69), the media PFS were 25.43 (16.09- 34.77)and 20.27 (15.04- 25.50) months (P=0.042). ⑦Cox analysis showed that CR after APBSCT and ISS stage were independent prognostic factors for OS. IgD type MM and CR after APBSCT were independent prognosis factor for PFS.
  
  
  CONCLUSIONS
  CR after APBSCT and ISS stage were independent prognostic factors for OS in MM. CR after APBSCT was independent prognostic factor for PFS in MM. However, disease progression more likely occurred in IgD type MM, which was independent negative prognostic factor for PFS in MM.
authors.affiliation: Department of Hematology, The Myeloma and Lymphoma Center, Chang Zheng Hospital, The Second Military Medical University, Shanghai 200003, China.
authors.forename: Lina
authors.initials: L
authors.lastname: Jin
authors.forename: Weijun
authors.initials: W
authors.lastname: Fu
authors.forename: Hao
authors.initials: H
authors.lastname: Xi
authors.forename: Chunyang
authors.initials: C
authors.lastname: Zhang
authors.forename: Juan
authors.initials: J
authors.lastname: Du
authors.forename: Haiyan
authors.initials: H
authors.lastname: He
authors.forename: Hua
authors.initials: H
authors.lastname: Jiang
authors.forename: Tianmei
authors.initials: T
authors.lastname: Zeng
authors.forename: Jianling
authors.initials: J
authors.lastname: Fan
authors.forename: Lili
authors.initials: L
authors.lastname: Zhou
authors.forename: Hong
authors.initials: H
authors.lastname: Chang
authors.affiliation: Department of Hematology, The Myeloma and Lymphoma Center, Chang Zheng Hospital, The Second Military Medical University, Shanghai 200003, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Hou
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols; D000069286:Bortezomib / Q000627:therapeutic use; D018572:Disease-Free Survival; D006801:Humans; D009101:Multiple Myeloma / Q000175:diagnosis / Q000628:therapy*; D020360:Neoadjuvant Therapy; D036102:Peripheral Blood Stem Cell Transplantation; D011379:Prognosis; D012074:Remission Induction; D015996:Survival Rate; D013792:Thalidomide / Q000627:therapeutic use; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D013792:Thalidomide; D000069286:Bortezomib