High‐dose melphalan‐based autotransplants for multiple myeloma

Open Access
Publisher Website
Google Scholar
Abstract
BACKGROUND: In this report, the authors describe their collective experience with melphalan‐based autotransplants since the inception of their program at the University of Arkansas for Medical Sciences in 1989.METHODS: The authors evaluated the clinical outcomes of 3077 successive patients with multiple myeloma (MM) who underwent at least 1 melphalan‐based autotransplantation at the University of Arkansas. Of these, 1078 patients were enrolled on front‐line Total Therapy (TT) protocols (TT‐P) TT1, TT2, and TT3; 1104 patients were entered on protocols for newly diagnosed or previously treated patients (non‐TT‐P); and 895 patients were treated off protocol (non‐P).RESULTS: The 10‐year overall survival (OS) rates after first transplantation were 41%, 19%, and 11% (P< .001) for the TT‐P, non‐TT‐P, and non‐P groups, respectively. In the TT‐P group, the median OS was 72 months on TT1, was not reached at ≥7 years on TT2, and was 88% at 2 years on TT3. Among 2683 patients with complete baseline data, absence of hypodiploidy/chromosome 13 deletion, β‐2‐microglobulin P< .001), event‐free survival (P< .001), and duration of complete remission (P< .001).CONCLUSIONS: The results from this large, single‐institution experience demonstrated that >10‐year OS was accomplished in >40% of all patients enrolled on TT‐P, whereas such success was observed in only 15% of the remaining patients (including 25% in the presence of all 5 good‐risk features). Superior outcomes with protocol‐based, primary transplant regimens such as TT‐P draw attention to the importance of applying the best available therapies upfront. Cancer 2008. © 2008 American Cancer Society.

This publication has 36 references indexed in Scilit: