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Prognostic impact of early-versus-late responses to different induction regimens in patients with myeloma undergoing autologous hematopoietic cell transplantation: Results from the CALM study by the CMWP of the EBMT

L. Garderet, G. Sbianchi, S. Iacobelli, D. Blaise, JL. Byrne, P. Remenyi, JF. Apperley, C. Touzeau, C. Isaksson, P. Browne, J. Mayer, S. Lenhoff, S. Gonzalez Muniz, R. Parody Porras, G. Basak, X. Poire, M. Trneny, A. Nagler, M. Michieli, A....

. 2021 ; 106 (5) : 708-715. [pub] 20210227

Jazyk angličtina Země Velká Británie

Typ dokumentu časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc22004391

Grantová podpora
UK NIHR Imperial college

BACKGROUND: In autologous stem cell transplant (ASCT)-eligible myeloma patients, prolonged induction does not necessarily improve the depth of response. METHOD: We analyzed 1222 ASCT patients who were classified based on (a) the interval between induction and stem cell collection, (b) the type of induction regimen: BID (Bortezomib, IMiDs, and Dexamethasone), Bortezomib-based, or CTD (Cyclophosphamide, Thalidomide, and Dexamethasone), and (c) the time to best response (Early ie, best response within 4 or 5 months, depending on the regimen vs Late; Good ie, VGPR or better vs Poor). RESULTS: The length of induction treatment required to achieve a Good response did not affect PFS (P = .65) or OS (P = .61) post-ASCT. The three types of regimen resulted in similar outcomes: median PFS 31, 27.7 and 30.8 months (P = .31), and median OS 81.7, 92.7, and 77.4 months, respectively (P = .83). On multivariate analysis, neither the type nor the duration of the induction regimen affected OS and PFS, except for Early Good Responders who had a better PFS compared to Early Poor Responders (HR = 1.21, P-value = .02). However, achieving a Good response at induction was associated with a better response (≥VGPR) post-transplant. CONCLUSION: The kinetics of response did not affect outcomes.

Citace poskytuje Crossref.org

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$a BACKGROUND: In autologous stem cell transplant (ASCT)-eligible myeloma patients, prolonged induction does not necessarily improve the depth of response. METHOD: We analyzed 1222 ASCT patients who were classified based on (a) the interval between induction and stem cell collection, (b) the type of induction regimen: BID (Bortezomib, IMiDs, and Dexamethasone), Bortezomib-based, or CTD (Cyclophosphamide, Thalidomide, and Dexamethasone), and (c) the time to best response (Early ie, best response within 4 or 5 months, depending on the regimen vs Late; Good ie, VGPR or better vs Poor). RESULTS: The length of induction treatment required to achieve a Good response did not affect PFS (P = .65) or OS (P = .61) post-ASCT. The three types of regimen resulted in similar outcomes: median PFS 31, 27.7 and 30.8 months (P = .31), and median OS 81.7, 92.7, and 77.4 months, respectively (P = .83). On multivariate analysis, neither the type nor the duration of the induction regimen affected OS and PFS, except for Early Good Responders who had a better PFS compared to Early Poor Responders (HR = 1.21, P-value = .02). However, achieving a Good response at induction was associated with a better response (≥VGPR) post-transplant. CONCLUSION: The kinetics of response did not affect outcomes.
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$a Apperley, Jane F $u Centre for Haematology, Imperial College, London, UK
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$a Basak, Grzegorz $u The Medical University of Warsaw, Warsaw, Poland
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$a Poire, Xavier $u Cliniques Universitaires St Luc, Brussels, Belgium
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$a Trneny, Marek $u Charles University Hospital, Prague, Czech Republic
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$a Nagler, Arnon $u Chaim Sheba Medical Center, Tel-Hashomer, Israel
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$a Michieli, Mariagrazia $u C.R.O IRCCS Aviano, Aviano, Italy
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$a Tanase, Alina $u Fundeni Clinical Institute, Bucarest, Romania
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$a Koster, Linda $u EBMT Data Office, Leiden, Netherlands
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$a Hayden, Patrick J $u Department of Haematology, Trinity College Dublin, St. James's Hospital, Dublin 8, Ireland
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$a Schönland, Stefan $u Medical Department V, University Hospital Heidelberg, Heidelberg, Germany
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