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Influence of pre- and post-transplantation responses on outcome of patients with multiple myeloma: sequential improvement of response and achievement of complete response are associated with longer survival.
J Clin Oncol. 2008 Dec 10; 26(35):5775-82.JC

Abstract

PURPOSE

Complete response (CR) is considered an important goal in most hematologic malignancies. However, in multiple myeloma (MM), there is no consensus regarding whether immunofixation (IF)-negative CR, IF-positive near-CR (nCR), and partial response (PR) are associated with different survivals. We evaluated the prognostic influence on event-free survival (EFS) and overall survival (OS) of these responses pre- and post-transplantation in newly diagnosed patients with MM.

PATIENTS AND METHODS

We analyzed 632 patients from the prospective Grupo Español de Mieloma 2000 protocol who were uniformly treated with vincristine, carmustine, cyclophosphamide, melphalan, and predisone/vincristine, carmustine, adryamcine, and dexamethasone induction followed by high-dose therapy and autologous stem-cell transplantation.

RESULTS

Post-transplantation response markedly influenced outcomes. Patients achieving CR had significantly longer EFS (median, 61 v 40 months; P < 10(-5)) and OS (medians not reached; P = .01) versus patients achieving nCR, who likewise had somewhat better outcomes compared with patients achieving PR (median EFS, 34 months, P = .07 v nCR; median OS, 61 months, P = .04). EFS and OS and influence of response were similar among older (age 65 to 70 years) and younger (age < 65 years) patients. Similar findings were observed with pretransplantation response, with trends toward EFS (P = .1; P = .05) and OS (P = .1; P = .07) benefit in patients achieving CR versus nCR and PR, respectively. Post-transplantation response was markedly influenced by pretransplantation response; improvements in response were associated with prolonged survival.

CONCLUSION

Quality of response post-transplantation, notably CR, is significantly associated with EFS and OS prolongation in newly diagnosed patients with MM. There were trends toward similar associations with pretransplantation response status.

Authors+Show Affiliations

Hospital Universitario de Salamanca, Salamanca, Spain.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19001321

Citation

Lahuerta, Juan José, et al. "Influence of Pre- and Post-transplantation Responses On Outcome of Patients With Multiple Myeloma: Sequential Improvement of Response and Achievement of Complete Response Are Associated With Longer Survival." Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, vol. 26, no. 35, 2008, pp. 5775-82.
Lahuerta JJ, Mateos MV, Martínez-López J, et al. Influence of pre- and post-transplantation responses on outcome of patients with multiple myeloma: sequential improvement of response and achievement of complete response are associated with longer survival. J Clin Oncol. 2008;26(35):5775-82.
Lahuerta, J. J., Mateos, M. V., Martínez-López, J., Rosiñol, L., Sureda, A., de la Rubia, J., García-Laraña, J., Martínez-Martínez, R., Hernández-García, M. T., Carrera, D., Besalduch, J., de Arriba, F., Ribera, J. M., Escoda, L., Hernández-Ruiz, B., García-Frade, J., Rivas-González, C., Alegre, A., Bladé, J., & San Miguel, J. F. (2008). Influence of pre- and post-transplantation responses on outcome of patients with multiple myeloma: sequential improvement of response and achievement of complete response are associated with longer survival. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, 26(35), 5775-82. https://doi.org/10.1200/JCO.2008.17.9721
Lahuerta JJ, et al. Influence of Pre- and Post-transplantation Responses On Outcome of Patients With Multiple Myeloma: Sequential Improvement of Response and Achievement of Complete Response Are Associated With Longer Survival. J Clin Oncol. 2008 Dec 10;26(35):5775-82. PubMed PMID: 19001321.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influence of pre- and post-transplantation responses on outcome of patients with multiple myeloma: sequential improvement of response and achievement of complete response are associated with longer survival. AU - Lahuerta,Juan José, AU - Mateos,Maria Victoria, AU - Martínez-López,Joaquin, AU - Rosiñol,Laura, AU - Sureda,Anna, AU - de la Rubia,Javier, AU - García-Laraña,José, AU - Martínez-Martínez,Rafael, AU - Hernández-García,Miguel T, AU - Carrera,Dolores, AU - Besalduch,Joan, AU - de Arriba,Felipe, AU - Ribera,José María, AU - Escoda,Lourdes, AU - Hernández-Ruiz,Belén, AU - García-Frade,Javier, AU - Rivas-González,Concepción, AU - Alegre,Adrían, AU - Bladé,Joan, AU - San Miguel,Jesús F, Y1 - 2008/11/10/ PY - 2008/11/13/pubmed PY - 2009/1/7/medline PY - 2008/11/13/entrez SP - 5775 EP - 82 JF - Journal of clinical oncology : official journal of the American Society of Clinical Oncology JO - J Clin Oncol VL - 26 IS - 35 N2 - PURPOSE: Complete response (CR) is considered an important goal in most hematologic malignancies. However, in multiple myeloma (MM), there is no consensus regarding whether immunofixation (IF)-negative CR, IF-positive near-CR (nCR), and partial response (PR) are associated with different survivals. We evaluated the prognostic influence on event-free survival (EFS) and overall survival (OS) of these responses pre- and post-transplantation in newly diagnosed patients with MM. PATIENTS AND METHODS: We analyzed 632 patients from the prospective Grupo Español de Mieloma 2000 protocol who were uniformly treated with vincristine, carmustine, cyclophosphamide, melphalan, and predisone/vincristine, carmustine, adryamcine, and dexamethasone induction followed by high-dose therapy and autologous stem-cell transplantation. RESULTS: Post-transplantation response markedly influenced outcomes. Patients achieving CR had significantly longer EFS (median, 61 v 40 months; P < 10(-5)) and OS (medians not reached; P = .01) versus patients achieving nCR, who likewise had somewhat better outcomes compared with patients achieving PR (median EFS, 34 months, P = .07 v nCR; median OS, 61 months, P = .04). EFS and OS and influence of response were similar among older (age 65 to 70 years) and younger (age < 65 years) patients. Similar findings were observed with pretransplantation response, with trends toward EFS (P = .1; P = .05) and OS (P = .1; P = .07) benefit in patients achieving CR versus nCR and PR, respectively. Post-transplantation response was markedly influenced by pretransplantation response; improvements in response were associated with prolonged survival. CONCLUSION: Quality of response post-transplantation, notably CR, is significantly associated with EFS and OS prolongation in newly diagnosed patients with MM. There were trends toward similar associations with pretransplantation response status. SN - 1527-7755 UR - https://www.unboundmedicine.com/medline/citation/19001321/Influence_of_pre__and_post_transplantation_responses_on_outcome_of_patients_with_multiple_myeloma:_sequential_improvement_of_response_and_achievement_of_complete_response_are_associated_with_longer_survival_ L2 - https://ascopubs.org/doi/10.1200/JCO.2008.17.9721?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -