Titre :

Melphalan 140 mg/m(2) or 200 mg/m(2) for autologous transplantation in myeloma: results from the Collaboration to Collect Autologous Transplant Outcomes in Lymphoma and Myeloma (CALM) study. A report by the EBMT Chronic Malignancies Working Party

Auteur(s) :

Auner Holger, W [Auteur]
Iacobelli, Simona [Auteur]
Sbianchi, Giulia [Auteur]
Knol-Bout, Cora [Auteur]
Blaise, Didier [Auteur]
Russell Nigel, H [Auteur]
Apperley Jane, F [Auteur]
Pohlreich, David [Auteur]
Browne Paul, V [Auteur]
Kobbe, Guido [Auteur]
Isaksson, Cecilia [Auteur]
Lenhoff, Stig [Auteur]
Scheid, Christof [Auteur]
Touzeau, Cyrille [Auteur]
Jantunen, Esa [Auteur]
Anagnostopoulos, Achilles [Auteur]
Yakoub-Agha, Ibrahim [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Tanase, Alina [Auteur]
Schaap, Nicolaas [Auteur]
Wiktor-Jedrzejczak, Wieslaw [Auteur]
Krejci, Marta [Auteur]
Schonland, Stefan [Auteur]
Morris, Curly [Auteur]
Garderet, Laurent [Auteur]
Kroger, Nicolaus [Auteur]

Titre de la revue :

Haematologica

Nom court de la revue :

Haematologica

Numéro :

103

Pagination :

514-521

Date de publication :

2018-03-01

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

Melphalan at a dose of 200 mg/m(2) is standard conditioning prior to autologous hematopoietic stem cell transplantation for multiple myeloma, but a dose of 140 mg/m(2) is often used in clinical practice in patients ...
Lire la suite >Melphalan at a dose of 200 mg/m(2) is standard conditioning prior to autologous hematopoietic stem cell transplantation for multiple myeloma, but a dose of 140 mg/m(2) is often used in clinical practice in patients perceived to be at risk of excess toxicity. To determine whether melphalan 200 mg/m(2) and melphalan 140 mg/m(2) are equally effective and tolerable in clinically relevant patient subgroups we analyzed 1964 first single autologous transplantation episodes using a series of Cox proportional-hazards models. Overall survival, progression-free survival, cumulative incidence of relapse, non-relapse mortality, hematopoietic recovery and second primary malignancy rates were not significantly different between the melphalan 140 mg/m(2) (n=245) and melphalan 200 mg/m(2) (n=1719) groups. Multivariable subgroup analysis showed that disease status at transplantation interacted with overall survival, progression-free survival, and cumulative incidence of relapse, with a significant advantage associated with melphalan 200 mg/m(2) in patients transplanted in less than partial response (adjusted hazard ratios for melphalan 200 mg/m(2)versus melphalan 140 mg/m(2): 0.5, 0.54, and 0.56). In contrast, transplantation in very good partial or complete response significantly favored melphalan 140 mg/m(2) for overall survival (adjusted hazard ratio: 2.02). Age, renal function, prior proteasome inhibitor treatment, gender, or Karnofsky score did not interact with overall/progression-free survival or relapse rate in the melphalan dose groups. There were no significant survival or relapse rate differences between melphalan 200 mg/m(2) and melphalan 140 mg/m(2) patients with high-risk or standard-risk chromosomal abnormalities. In conclusion, remission status at the time of transplantation may favor the use of melphalan 200 mg/m(2) or melphalan 140 mg/m(2) for key transplant outcomes (NCT01362972).Lire moins >

Langue :

Anglais

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

Inserm
Université de Lille
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Équipe(s) de recherche :

Immunity, inflammation and fibrsis in auto and allo-reactivity

Date de dépôt :

2019-03-01T14:09:28Z
2024-01-23T11:54:38Z