Early response-based intensification of primary therapy in newly diagnosed multiple myeloma patients who are eligible for autologous stem cell transplantation: Phase II study

Seo Yeon Ahn, Sung Hoon Jung, Young Don Joo, Won Sik Lee, Sang Min Lee, Chul Won Choi, Seok Jin Kim, Kihyun Kim, Je Jung Lee

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

This phase II study prospectively evaluated the efficacy and tolerability of an early change in induction therapy before autologous stem cell transplantation (ASCT) in multiple myeloma (MM) patients who failed to achieve more than a partial response (PR) after two cycles of a cyclophosphamide, thalidomide, and dexamethasone (CTD) regimen. Patients aged 18-65 years received two cycles of CTD therapy, and then the patients who achieved more than a PR received two additional cycles of CTD therapy, while those who failed to achieve more than a PR were given intensified therapy with four cycles of a Vel-CD regimen (bortezomib, cyclophosphamide, and dexamethasone). After completing primary chemotherapy, the patients underwent ASCT. This study initially enrolled 64 patients, although four were excluded. Of the patients, 60 were treated with CTD regimen and 8 patients also had the intensified Vel-CD regimen, of whom five showing improved responses. The overall response rate before ASCT in 59 patients was 94.9 %, including 27.1 % with a stringent complete response/complete response, 23.7 % with a very good partial response (VGPR), and 44.1 % with a PR. The median time to progression (TTP) was 33.2 months (95 % CI, 26.6-34.8). Patients who attained a VGPR or better after ASCT tended to have a longer TTP than the patients who did not (not reached vs. 24.2 months, P=0.04). In conclusion, early response-adapted intensification with a Vel-CD regimen was a well-tolerated, effective strategy for improving the response before ASCT in patients with newly diagnosed MM.

Original languageEnglish
Pages (from-to)1571-1577
Number of pages7
JournalAnnals of Hematology
Volume93
Issue number9
DOIs
Publication statusPublished - 2014 Jan 1

Fingerprint

Stem Cell Transplantation
Multiple Myeloma
Thalidomide
Cyclophosphamide
Dexamethasone
Therapeutics
Drug Therapy

Keywords

  • Bortezomib
  • Induction chemotherapy
  • Multiple myeloma
  • Thalidomide

ASJC Scopus subject areas

  • Hematology

Cite this

Early response-based intensification of primary therapy in newly diagnosed multiple myeloma patients who are eligible for autologous stem cell transplantation : Phase II study. / Ahn, Seo Yeon; Jung, Sung Hoon; Joo, Young Don; Lee, Won Sik; Lee, Sang Min; Choi, Chul Won; Kim, Seok Jin; Kim, Kihyun; Lee, Je Jung.

In: Annals of Hematology, Vol. 93, No. 9, 01.01.2014, p. 1571-1577.

Research output: Contribution to journalArticle

Ahn, Seo Yeon ; Jung, Sung Hoon ; Joo, Young Don ; Lee, Won Sik ; Lee, Sang Min ; Choi, Chul Won ; Kim, Seok Jin ; Kim, Kihyun ; Lee, Je Jung. / Early response-based intensification of primary therapy in newly diagnosed multiple myeloma patients who are eligible for autologous stem cell transplantation : Phase II study. In: Annals of Hematology. 2014 ; Vol. 93, No. 9. pp. 1571-1577.
@article{112e993a9c0c446fbff652c38174d8a4,
title = "Early response-based intensification of primary therapy in newly diagnosed multiple myeloma patients who are eligible for autologous stem cell transplantation: Phase II study",
abstract = "This phase II study prospectively evaluated the efficacy and tolerability of an early change in induction therapy before autologous stem cell transplantation (ASCT) in multiple myeloma (MM) patients who failed to achieve more than a partial response (PR) after two cycles of a cyclophosphamide, thalidomide, and dexamethasone (CTD) regimen. Patients aged 18-65 years received two cycles of CTD therapy, and then the patients who achieved more than a PR received two additional cycles of CTD therapy, while those who failed to achieve more than a PR were given intensified therapy with four cycles of a Vel-CD regimen (bortezomib, cyclophosphamide, and dexamethasone). After completing primary chemotherapy, the patients underwent ASCT. This study initially enrolled 64 patients, although four were excluded. Of the patients, 60 were treated with CTD regimen and 8 patients also had the intensified Vel-CD regimen, of whom five showing improved responses. The overall response rate before ASCT in 59 patients was 94.9 {\%}, including 27.1 {\%} with a stringent complete response/complete response, 23.7 {\%} with a very good partial response (VGPR), and 44.1 {\%} with a PR. The median time to progression (TTP) was 33.2 months (95 {\%} CI, 26.6-34.8). Patients who attained a VGPR or better after ASCT tended to have a longer TTP than the patients who did not (not reached vs. 24.2 months, P=0.04). In conclusion, early response-adapted intensification with a Vel-CD regimen was a well-tolerated, effective strategy for improving the response before ASCT in patients with newly diagnosed MM.",
keywords = "Bortezomib, Induction chemotherapy, Multiple myeloma, Thalidomide",
author = "Ahn, {Seo Yeon} and Jung, {Sung Hoon} and Joo, {Young Don} and Lee, {Won Sik} and Lee, {Sang Min} and Choi, {Chul Won} and Kim, {Seok Jin} and Kihyun Kim and Lee, {Je Jung}",
year = "2014",
month = "1",
day = "1",
doi = "10.1007/s00277-014-2067-3",
language = "English",
volume = "93",
pages = "1571--1577",
journal = "Annals of Hematology",
issn = "0939-5555",
publisher = "Springer Verlag",
number = "9",

}

TY - JOUR

T1 - Early response-based intensification of primary therapy in newly diagnosed multiple myeloma patients who are eligible for autologous stem cell transplantation

T2 - Phase II study

AU - Ahn, Seo Yeon

AU - Jung, Sung Hoon

AU - Joo, Young Don

AU - Lee, Won Sik

AU - Lee, Sang Min

AU - Choi, Chul Won

AU - Kim, Seok Jin

AU - Kim, Kihyun

AU - Lee, Je Jung

PY - 2014/1/1

Y1 - 2014/1/1

N2 - This phase II study prospectively evaluated the efficacy and tolerability of an early change in induction therapy before autologous stem cell transplantation (ASCT) in multiple myeloma (MM) patients who failed to achieve more than a partial response (PR) after two cycles of a cyclophosphamide, thalidomide, and dexamethasone (CTD) regimen. Patients aged 18-65 years received two cycles of CTD therapy, and then the patients who achieved more than a PR received two additional cycles of CTD therapy, while those who failed to achieve more than a PR were given intensified therapy with four cycles of a Vel-CD regimen (bortezomib, cyclophosphamide, and dexamethasone). After completing primary chemotherapy, the patients underwent ASCT. This study initially enrolled 64 patients, although four were excluded. Of the patients, 60 were treated with CTD regimen and 8 patients also had the intensified Vel-CD regimen, of whom five showing improved responses. The overall response rate before ASCT in 59 patients was 94.9 %, including 27.1 % with a stringent complete response/complete response, 23.7 % with a very good partial response (VGPR), and 44.1 % with a PR. The median time to progression (TTP) was 33.2 months (95 % CI, 26.6-34.8). Patients who attained a VGPR or better after ASCT tended to have a longer TTP than the patients who did not (not reached vs. 24.2 months, P=0.04). In conclusion, early response-adapted intensification with a Vel-CD regimen was a well-tolerated, effective strategy for improving the response before ASCT in patients with newly diagnosed MM.

AB - This phase II study prospectively evaluated the efficacy and tolerability of an early change in induction therapy before autologous stem cell transplantation (ASCT) in multiple myeloma (MM) patients who failed to achieve more than a partial response (PR) after two cycles of a cyclophosphamide, thalidomide, and dexamethasone (CTD) regimen. Patients aged 18-65 years received two cycles of CTD therapy, and then the patients who achieved more than a PR received two additional cycles of CTD therapy, while those who failed to achieve more than a PR were given intensified therapy with four cycles of a Vel-CD regimen (bortezomib, cyclophosphamide, and dexamethasone). After completing primary chemotherapy, the patients underwent ASCT. This study initially enrolled 64 patients, although four were excluded. Of the patients, 60 were treated with CTD regimen and 8 patients also had the intensified Vel-CD regimen, of whom five showing improved responses. The overall response rate before ASCT in 59 patients was 94.9 %, including 27.1 % with a stringent complete response/complete response, 23.7 % with a very good partial response (VGPR), and 44.1 % with a PR. The median time to progression (TTP) was 33.2 months (95 % CI, 26.6-34.8). Patients who attained a VGPR or better after ASCT tended to have a longer TTP than the patients who did not (not reached vs. 24.2 months, P=0.04). In conclusion, early response-adapted intensification with a Vel-CD regimen was a well-tolerated, effective strategy for improving the response before ASCT in patients with newly diagnosed MM.

KW - Bortezomib

KW - Induction chemotherapy

KW - Multiple myeloma

KW - Thalidomide

UR - http://www.scopus.com/inward/record.url?scp=84905595429&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84905595429&partnerID=8YFLogxK

U2 - 10.1007/s00277-014-2067-3

DO - 10.1007/s00277-014-2067-3

M3 - Article

C2 - 24728664

AN - SCOPUS:84905595429

VL - 93

SP - 1571

EP - 1577

JO - Annals of Hematology

JF - Annals of Hematology

SN - 0939-5555

IS - 9

ER -