scholarly journals 2',5'-Oligoadenylate synthetase levels in patients with multiple myeloma receiving maintenance therapy with interferon alpha 2b do not correlate with clinical response

1995 ◽  
Vol 72 (6) ◽  
pp. 1525-1530 ◽  
Author(s):  
BC Millar ◽  
JBG Bell
Keyword(s):  
Multiple Myeloma ◽  
Maintenance Therapy ◽  
Clinical Response ◽  
Interferon Alpha ◽  
Oligoadenylate Synthetase ◽  
Interferon Alpha 2B

Thalidomide-Dexamethasone Versus Melphalan-Prednisolone as First Line Treatment in Elderly Patients with Multiple Myeloma: An Interim Analysis.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 782-782 ◽  
Author(s):  
Heinz Ludwig ◽  
Johannes Drach ◽  
Elena Tóthová ◽  
Heinz Gisslinger ◽  
Werner Linkesch ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Elderly Patients ◽  
Interferon Alpha ◽  
Survival Data ◽  
Response Rate ◽  
Skin Toxicity ◽  
Thromboembolic Complications ◽  
Interferon Alpha 2B ◽  
Best Response ◽  
Present Trial

Abstract Thalidomide-Dexamethasone (TD) is an active regimen in patients with relapsing/refractory multiple myeloma (MM). Recent phase II and III studies revealed an even higher response rate in previously untreated patients. In the present trial we compare TD with standard Melphalan-Prednisone (MP) in previously untreated elderly patients with multiple myeloma. The trial is designed to include 350 pts with MM, 190 patients have been enrolled so far (median age: 72 years, stage I: 9 (5%), stage II: 61 (32%), stage III: 120 (63%). Patients are randomized to Thalidomide 200mg/day and Dexamethasone 40mg, days 1–4 and 15–18 (on odd cycles) and days 1–4 (on even cycles) or Melphalan 2.5mg/kg day 1–4 and Prednisone 2mg/kg days 1–4, q 4–6 weeks. Thalidomide should be dosed up to 400mg/day, if feasible. Patients achieving response or stabilization are randomized to maintenance treatment either with Thalidomide (maximal dose 200mg/day)-Interferon alpha-2b (3Mega U, TIW) or Interferon alpha-2b (3Mega U/TIW). All patients are scheduled for monthly Zometa (4mg) during the entire period. Response is defined according Blade’s criteria, statistical results are given by intend to treat analysis. 125 patients are evaluable for response as yet. Best response to TD was: CR 6 (10%), NCR 7 (12%), and VGPR 9 (15%) PR 9 (15%), MR 10 (16%) yielding an ORR of 67%. Four pts had SD (7%) and 16 PD or failure (26%). The respective results in pts on MP were: CR 2 (3%), NCR 4 (6%), VGPR 5 (8%), PR 13 (20%), MR 7 (11%), ORR 48% (p<0.05). Analysis per protocol revealed an ORR of 89% in the TD and 66% in the MP group (p<0.02). Time to response and time to best response was significantly shorter in the TD (8, 11 weeks, respectively) compared to the MP group (10, 39 weeks, respectively; p<0.01, p<0.0047, respectively). Due to the interim nature of the analysis, survival data will be presented only for both groups combined at the meeting. Grade III-IV thrombocytopenia was more frequent and leucopoenia was statistically significant more common in pts on MP (4 (7%) vs. 1 (2%); ns. and (8 (13%) vs. 1 (2%); p< 0.05, respectively). Patients on TD had more grade II-III neuropathy 15 (25%), psychological toxicity 12 (20%) and, skin toxicity 7 (12%) compared to those on MP (5 (8%), 5 (8%), 3 (3%), respectively). Thromboembolic complications were seen in 5 (8%) pts on TD and in 2 (3%) on MP. In conclusion, time to response and time to best response was significantly shorter in pts on TD. Both, the intend to treat and per protocol analysis showed a higher response rate in TD treated pts (67% vs. 48%, p<0.05 and 89% vs. 66%, p<0.02, respectively). Leucopoenia was more frequent in pts on MP and neuropathy more common in TD treated pts. There was a tendency for increased incidence of thromboembolic complications, psychological disturbances and skin toxicity in pts on TD. In relation to the high median age (72 years) of pts studied, TD was well tolerated.

Interferon Alpha 2b as Maintenance Therapy Improves Outcome In Follicular Lymphoma

2004 ◽  
Vol 45 (11) ◽  
pp. 2247-2251 ◽  
Author(s):  
Agustin Avilés ◽  
Natividad Neri ◽  
Judith Huerta-Guzmán ◽  
Felipe Pérez ◽  
León Sotelo
Keyword(s):  
Maintenance Therapy ◽  
Follicular Lymphoma ◽  
Interferon Alpha ◽  
Interferon Alpha 2B

Effect of interferon alpha-2b in advanced multiple myeloma

1990 ◽  
Vol 227 (1) ◽  
pp. 45-48 ◽  
Author(s):  
S. RÖDJER ◽  
O. VIKROT ◽  
A. WAHLIN ◽  
J. WESTIN
Keyword(s):  
Multiple Myeloma ◽  
Interferon Alpha ◽  
Interferon Alpha 2B

scholarly journals Successful Management of Transplant-Ineligible Patients with Refractory/Relapsed Multiple Myeloma By Using a Biweekly or Longer Modified Bortezomib Schedule As Interval Maintenance therapy

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 5758-5758
Author(s):  
Michihide Tokuhira ◽  
Yuta Kimura ◽  
Tatsuki Tomikawa ◽  
Yasuyuki Takahashi ◽  
Morihiko Sagawa ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Maintenance Therapy ◽  
Clinical Response ◽  
Median Duration ◽  
Induction Therapy ◽  
Response Rate ◽  
Median Number ◽  
Clinical Response Rate ◽  
Molecular Response

Abstract Background: Substantial efficacy has been demonstrated with bortezomib (Bor)-containing regimens for the treatment of refractory/relapsed (RR) patients with transplant-ineligible (TI) multiple myeloma (MM). However, the dosing schedules for induction therapy and the significance of maintenance therapy using Bor in clinical settings have yet to be standardized. Discontinuations and dose reduction of Bor owing to severe adverse events (AEs) such as peripheral neuropathy (PN) and infection are frequent causes of adjustments to the standard 9 cycles of Bor/dexamethasone (BD) therapy used for induction in clinical practice. We have previously demonstrated that a change in Bor administration to a schedule of weekly or longer intervals had similar or greater efficacy for patients with RR-MM including transplant-eligible (Tokuhira M, et al. Leuk Res. 35:591-7, 2011). To investigate the efficacy of this modified Bor dosing schedule in the treatment focusing of TI-RR-MM, we retrospectively analyzed 22 patients receiving weekly-BD induction followed by a modified schedule of biweekly or longer intervals using Bor as maintenance therapy in a single institution. Methods: Data on the 22 TI-RR-MM patients treated with BD therapy in our institution were retrospectively analyzed. The induction therapy consisted of intravenous injections of Bor (1.3 mg/m2) on days 1, 8, 15, and 22 in combination with dexamethasone (10–20 mg) on days 1 and 2 after Bor infusion, every 5 weeks. After BD induction, Bor maintenance was initiated with a schedule of biweekly or longer intervals. The dose of BD could be reduced based on AEs or other social aspects at the discretion of the treating physician. Overall survival (OS) was defined as the period between BD initiation of treatment to the last follow-up. Results: The median age of patients at the time of BD induction was 72.6 years (range, 49–84 years), and the subtypes of MM were the IgG type in 14 patients, IgA type in 6 patients, and BJP in 2 patients. Twelve patients were men and 10 were women. On the basis of the International Staging System classification, the clinical stage was I in 3 patients, II in 16 patients, and III in 3 patients. The median number of prior treatment regimens was 2.0 (range, 1–6). The median follow-up duration was 4.3 years (inter-quartile range, 3.0–7.8 years). Ten patients were alive, and 12 patients had died at the time of reporting. The median duration from the start of the first line treatment to BD initiation was 1.8 years (range, 0.1–14.8 years). The median number of BD induction cycles was 2.0 (range, 1–6), and 8 patients (36%) achieved a partial response (PR), although the other 14 patients (64%) showed stable disease or only a minimal response. Although AEs such as PN and gastrointestinal tract symptoms developed in 10 of 22 patients during BD induction, all 22 patients could move on to the maintenance phase. The median duration of Bor maintenance was 14.5 months (range, 1.8–76.5 months). Three patients were still receiving maintenance therapy at the time of reporting. Six patients (27.2%) received maintenance therapy for over 2 years, and 3 (13.6%) received it for over 4 years. The median OS was 3.6 years (range, 0.4–6.5 years), and the duration of Bor therapy from induction to the last administration was 2.5 years. The median progression free survival was 1.6 years (range, 0.3–6.5 years). During maintenance therapy, 5 patients achieved a PR. The reasons for cessation of Bor maintenance therapy were AEs in 8 patients and progressive disease in 11 patients. No patient died during Bor administration in this study. Discussion: We retrospectively analyzed 22 TI-RR-MM patients receiving modified BD therapy. Pantani L et al. reported the results of using BD therapy for 85 RR-MM patients, and demonstrated that twice-weekly Bor administration resulted in a clinical response rate of 19% and a median OS of 22 months (Ann Hematol, 2014). Although the clinical response rate in our study was inferior to that of Pantani L et al., the median OS in our study was superior (3.6 years) than those of previous reports. Because the majority of patients in this study were frail or elderly, the early decision to change to maintenance therapy before they developed severe AEs resulted in a good clinical outcome and a longer OS. Continuing BD therapy without a satisfactory molecular response might be an attractive therapeutic approach for TI-RR-MM patients. Disclosures No relevant conflicts of interest to declare.

scholarly journals Interferon-alpha as maintenance therapy in patients with multiple myeloma

2005 ◽  
Vol 16 (12) ◽  
pp. 1981 ◽  
Author(s):  
B. Yalcin ◽  
M. Dogan ◽  
A. Buyukcelik ◽  
H. Doruk ◽  
I. Tek ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Maintenance Therapy ◽  
Interferon Alpha
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