title: The clinical impact of thalidomide maintenance after autologous stem cell transplantation in patients with newly diagnosed multiple myeloma in real clinical practice of Korea.
abstract: In real clinical settings (not clinical trials), thalidomide has been accepted as maintenance therapy to patients with multiple myeloma (MM) because of the cost of drugs, the limitations of medical insurance, etc., in our country (South Korea). The purpose of this study was to evaluate the utility of thalidomide maintenance for improving survival in transplantation-eligible patients with MM in the real clinical field. Differences in survival rates were estimated in patients treated with or without thalidomide maintenance. The 3-year progression-free survival rates (PFS) of patients with and without maintenance, respectively, were 55.4 and 37.2 % (p = 0.005). The 3-year overall survival rates (OS) were 88.0 and 84.0 % (p = 0.105). No difference in 3-year OS after relapse or progression (OS2) was observed between the two groups (50.4 and 55.3 %, p = 0.661). The 3-year PFS of patients with and without maintenance therapy who had shown less than CR after ASCT were 68.4 and 23.3 % (p < 0.001). In conclusion, Thalidomide maintenance therapy showed longer PFS in real clinical practice, and long-term use of thalidomide did not interfere with the efficacy of salvage chemotherapy in patients who experienced progression or relapse after ASCT. In addition, thalidomide maintenance might be also useful for patients who have shown less than CR after ASCT.
authors.affiliation: Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea.
authors.forename: Ho Sup
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Hematology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 505, Banpo-dong, Seocho-gu, Seoul, 137-701, South Korea. ckmin@catholic.ac.kr.
authors.forename: Chang-Ki
authors.initials: CK
authors.lastname: Min
authors.affiliation: Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Hwasun, Jeollanamdo, South Korea.
authors.forename: Je-Jung
authors.initials: JJ
authors.lastname: Lee
authors.affiliation: Department of Medicine, Samsung Medical Center, Sunkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Kihyun
authors.initials: K
authors.lastname: Kim
authors.affiliation: Department of Medicine, Samsung Medical Center, Sunkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Seok Jin
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Dok Hyun
authors.initials: DH
authors.lastname: Yoon
authors.affiliation: Department of Internal Medicine, National Cancer Center of Korea, Goyang, South Korea.
authors.forename: Hyeon-Seok
authors.initials: HS
authors.lastname: Eom
authors.affiliation: Department of Internal Medicine, National Cancer Center of Korea, Goyang, South Korea.
authors.forename: Hyewon
authors.initials: H
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Busan Paik Hospital, Busan, South Korea.
authors.forename: Won Sik
authors.initials: WS
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Pusan National University Hospital, Busan, South Korea.
authors.forename: Ho-Jin
authors.initials: HJ
authors.lastname: Shin
authors.affiliation: Department of Internal Medicine, Dong-A University College of Medicine, Busan, South Korea.
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea.
authors.forename: Yong
authors.initials: Y
authors.lastname: Park
authors.affiliation: Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea.
authors.forename: Jae-Cheol
authors.initials: JC
authors.lastname: Jo
authors.affiliation: Department of Hemato-Oncology, Keimyung University Dongsan Medical Center, Daegu, South Korea.
authors.forename: Young Rok
authors.initials: YR
authors.lastname: Do
authors.affiliation: Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, South Korea.
authors.forename: Yeung-Chul
authors.initials: YC
authors.lastname: Mun
authors.affiliation: Division of Hematology-Oncology, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, South Korea.
authors.forename: Mark Hong
authors.initials: MH
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000401:mortality* / Q000639:trends*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013792:Thalidomide / Q000008:administration & dosage*; D014182:Transplantation, Autologous / Q000401:mortality / Q000639:trends; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D013792:Thalidomide
keywords: Maintenance; Multiple myeloma; Survival; Thalidomide; Transplantation