Treatment outcome and prognostic factor analysis in transplant-eligible Chinese myeloma patients receiving bortezomib-based induction regimens including the staged approach, PAD ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2012-06-08

AUTHORS

Chor Sang Chim, Albert Kwok Wai Lie, Eric Yuk Tat Chan, Herman Sung Yu Liu, Ching Wa Lau, Sze Fai Yip, Joycelyn Sim, Thomas Shek-Kong Wan, Edmond Shiu-Kwan Ma, Raymond Liang, Eric Tse, Yok-Lam Kwong, for Hong Kong Society of Myeloma

ABSTRACT

BackgroundWe have reported promising outcomes using a staged approach, in which bortezomib/thalidomide/dexamethasone was used only in 14 patients with suboptimal response to VAD (vincristine/adriamycin/dexamethasone) before autologous stem cell transplantation (ASCT). Here we compared the outcomes of the staged approach with frontline PAD (bortezomib/doxorubicin/dexamethasone) or VTD (bortezomib/thalidomide/dexamethasone) induction, and analysed prognostic factors for outcome.Patients and methodsNinety-one transplant-eligible Chinese patients received three induction regimens prior to ASCT [staged approach (N = 25), PAD (N = 31), VTD (N = 35)]. and received thalidomide maintenance for 2 years post-ASCT.Results43 (47.3%) patients had International Staging System (ISS) III disease. By an intention-to-treat analysis, the overall CR/nCR rate were 37.4% post-induction, and 62.6% post-ASCT. Five-year overall (OS) and event-free (EFS) survivals were 66% and 45.1%. There was no difference of the post-induction CR/nCR rate, EFS or OS between patients induced by these three regimens. Moreover, ISS III disease did not affect CR/nCR rates. Multivariate analysis showed that ISS and post-ASCT CR/nCR impacted OS while ISS and post-induction CR/nCR impacted EFS.ConclusionsThese three induction regimens produced comparable and favorable outcomes in myeloma. The unfavorable outcome of ISS stage III persisted despite upfront/early use of bortezomib. CR/nCR predicted favorable survivals. More... »

PAGES

28

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/1756-8722-5-28

DOI

http://dx.doi.org/10.1186/1756-8722-5-28

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1008861500

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/22682027


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45 OS
46 Overall
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49 analysis
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54 cell transplantation
55 dexamethasone
56 differences
57 disease
58 early use
59 event-free survival
60 factor analysis
61 factors
62 favorable outcome
63 favorable survival
64 induction
65 induction regimens
66 intention
67 maintenance
68 multivariate analysis
69 myeloma
70 myeloma patients
71 nCR rate
72 outcomes
73 pads
74 patients
75 post-ASCT
76 prognostic factor analysis
77 prognostic factors
78 promising outcomes
79 rate
80 regimens
81 response
82 stage III
83 stem cell transplantation
84 suboptimal response
85 survival
86 thalidomide maintenance
87 thalidomide/dexamethasone
88 transplantation
89 treat analysis
90 treatment outcomes
91 unfavorable outcome
92 use
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