医学
硼替佐米
内科学
地塞米松
多发性骨髓瘤
沙利度胺
移植
造血干细胞移植
肿瘤科
自体干细胞移植
化疗
外科
养生
泌尿科
环磷酰胺
作者
Laurent Garderet,Giulia Sbianchi,Simona Iacobelli,Didier Blaise,Jenny Byrne,Péter Reményi,Jane F. Apperley,Cyrille Touzeau,Cecilia Isaksson,Paul Browne,Jiřı́ Mayer,Stig Lenhoff,Soledad González Muñiz,Rocío Parody Porras,Grzegorz W. Basak,Xavier Poiré,Marek Trněný,Arnon Nagler,Mariagrazia Michieli,Alina Tănase,Linda Köster,Patrick Hayden,Meral Beksaç,Stefan Schönland,Ibrahim Yakoub‐Agha
摘要
In autologous stem cell transplant (ASCT)-eligible myeloma patients, prolonged induction does not necessarily improve the depth of response.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).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.The kinetics of response did not affect outcomes.