scholarly journals Early myeloablative therapy for multiple myeloma

Blood ◽  
1994 ◽  
Vol 84 (12) ◽  
pp. 4278-4282 ◽  
Author(s):  
R Alexanian ◽  
MA Dimopoulos ◽  
J Hester ◽  
K Delasalle ◽  
R Champlin
Keyword(s):  
Multiple Myeloma ◽  
Autologous Bone Marrow ◽  
Initial Therapy ◽  
Intensive Treatment ◽  
First Year ◽  
Disease Course ◽  
Survival Times ◽  
Resistant Disease ◽  
Disease Outcomes ◽  
Autologous Bone

The value of early myeloablative therapy supported by autologous bone marrow or blood progenitor cells was assessed in 72 patients with multiple myeloma who were treated within 1 year of initial therapy. Forty-five patients were consolidated during remission, and 27 patients were treated for primary refractory disease. Outcomes were compared with those of similar patients who did not receive intensive treatment primarily for socioeconomic reasons. Among patients who had responded previously, myeloablative therapy increased the rate of complete remission from 5% to 45% (P < .01) but did not prolong progression-free intervals or survival times. The same treatment controlled the myeloma in 70% of patients with primary resistant disease and prolonged the median survival from 37 to 83 months (P = .03). Intensive treatment for primary resistant myeloma administered later in the disease course resulted in significantly lower response rates and shorter progression- free intervals. Current myeloablative regimens supported by autologous stem cells appeared useful primarily in patients with primary resistant disease during the first year of therapy.

scholarly journals Limited value of myeloablative therapy for late multiple myeloma

Blood ◽  
1994 ◽  
Vol 83 (2) ◽  
pp. 512-516 ◽  
Author(s):  
R Alexanian ◽  
M Dimopoulos ◽  
T Smith ◽  
K Delasalle ◽  
B Barlogie ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Response Rate ◽  
Autologous Bone Marrow ◽  
First Year ◽  
Primary Resistance ◽  
Prior Chemotherapy ◽  
Resistant Disease ◽  
Blood Stem Cells ◽  
Pulse Dexamethasone ◽  
Autologous Bone

Abstract The utility of myeloablative therapy supported by autologous bone marrow (BM) or blood progenitor cells was assessed in 49 patients with multiple myeloma who had received at least 1 year of prior chemotherapy. Outcomes were compared with those of similar patients who did not receive intensive treatment primarily for socioeconomic reasons. Among patients with disease in resistant relapse despite treatment with vincristine-doxorubicin by continuous infusion with pulse dexamethasone (VAD), a 61% response rate was associated with a median remission time of 5 months. After primary resistance for more than 1 year, 6 of 15 patients responded and the overall survival was similar to that of control patients. For patients with melphalan- resistant disease that responded to VAD, the remission time was similar to that of control patients. Current myeloablative treatments supported by autologous BM or blood stem cells were useful to very few patients with multiple myeloma after the first year of chemotherapy.

scholarly journals Limited value of myeloablative therapy for late multiple myeloma

Blood ◽  
1994 ◽  
Vol 83 (2) ◽  
pp. 512-516
Author(s):  
R Alexanian ◽  
M Dimopoulos ◽  
T Smith ◽  
K Delasalle ◽  
B Barlogie ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Response Rate ◽  
Autologous Bone Marrow ◽  
First Year ◽  
Primary Resistance ◽  
Prior Chemotherapy ◽  
Resistant Disease ◽  
Blood Stem Cells ◽  
Pulse Dexamethasone ◽  
Autologous Bone

The utility of myeloablative therapy supported by autologous bone marrow (BM) or blood progenitor cells was assessed in 49 patients with multiple myeloma who had received at least 1 year of prior chemotherapy. Outcomes were compared with those of similar patients who did not receive intensive treatment primarily for socioeconomic reasons. Among patients with disease in resistant relapse despite treatment with vincristine-doxorubicin by continuous infusion with pulse dexamethasone (VAD), a 61% response rate was associated with a median remission time of 5 months. After primary resistance for more than 1 year, 6 of 15 patients responded and the overall survival was similar to that of control patients. For patients with melphalan- resistant disease that responded to VAD, the remission time was similar to that of control patients. Current myeloablative treatments supported by autologous BM or blood stem cells were useful to very few patients with multiple myeloma after the first year of chemotherapy.

scholarly journals High-dose chemoradiotherapy and autologous bone marrow transplantation for resistant multiple myeloma

Blood ◽  
1987 ◽  
Vol 70 (3) ◽  
pp. 869-872 ◽  
Author(s):  
B Barlogie ◽  
R Alexanian ◽  
KA Dicke ◽  
G Zagars ◽  
G Spitzer ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Marrow Transplantation ◽  
Autologous Bone Marrow Transplantation ◽  
Autologous Bone Marrow ◽  
High Dose ◽  
Autologous Bone ◽  
Total Body ◽  
High Dose Melphalan

Abstract Seven patients with advanced multiple myeloma, refractory to therapy with alkylating agent-VAD (vincristine-adriamycin-dexamethasone), received a regimen combining high-dose melphalan with total body irradiation supported by autologous bone marrow transplantation. Very rapid, usually greater than 90% tumor mass reduction was achieved in six patients, regardless of prior chemotherapy responsiveness and marrow plasmacytosis up to 30%. Despite signs of early relapse in three patients (median remission duration of all patients, 15 months), five remain alive and well without further cytotoxic therapy from 2 to 21 months (median, 9+ months). Two patients died, one from surgical complications after transplantation and a second due to persistent neutropenia with fatal pneumonia. This treatment provides meaningful disease control for selected patients with resistant myeloma and a poor prognosis.

Impact of race/ethnicity in the clinical presentation and outcomes of patients with multiple myeloma in an underserved urban population.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 6570-6570
Author(s):  
Christian Torres ◽  
Xavier Alberto Andrade Gonzalez ◽  
Vatsala Katiyar ◽  
Juan Del Cid ◽  
Andres Mendez Hernandez ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow ◽  
High Risk ◽  
Ethnic Groups ◽  
Urban Population ◽  
Clinical Presentation ◽  
Autologous Bone Marrow ◽  
Race Ethnicity ◽  
Autologous Bone ◽  
Racial Ethnic

6570 Background: Patients with multiple myeloma (MM) who are part of racial/ethnic minority groups have been typically underrepresented in large descriptive and randomized-controlled studies. Despite the identification of biological and genetic risk factors, the impact of race/ethnicity in the outcomes of patients with MM remains largely unknown. We aimed to describe the racial/ethnic differences in clinical presentation and outcomes of patients with MM in an ethnically-diverse underserved urban population. Methods: We conducted a single-center retrospective study of patients with MM from Jan 1st 2008 – Dec 31st 2016 using ICD coding from our tumor registry. We abstracted demographic, clinical and treatment variables. We used Chi-square to compare categorical variables and Kaplan-Meier method for survival analysis. Statistical analysis was performed using IBM SPSS version 25. Results: We identified 73 patients with MM with a median follow up time of 42 months (Range 1 to 81 months). Patients had a median age of 59 years (Interquartile Range [IQR] =17) and were predominantly male (54.8%). The most frequent racial/ethnic group was African American (AA) (59%) followed by Hispanic (27%) and Caucasian (8%). When compared to other ethnicities, patients who were AA had higher ISS-3 scores (41% vs 23% p=0.101) worse cytogenetic risk (65% vs 30% p=0.009) and worse response after induction (Complete response [CR] 47% vs 77% p=0.047). They were also more likely to have medical insurance coverage than other ethnicities (67% vs 27% p=0.003) but had similar access to autologous bone marrow transplant (23% vs 23% p= 0.99). Overall, AA patients had worse overall survival (OS) compared to all other ethnic groups (mean OS: 58.3 months vs 79 months p=0.014). Conclusions: AA patients with MM had more aggressive disease and worse OS compared to other ethnicities which may suggest an underlying genetic predisposition towards high-risk genetic features. Improvement of access to autologous bone marrow transplantation may improve survival in high-risk racial/ethnic groups.

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