Prospective comparison of autologous stem cell transplantation followed by dose-reduced allograft (IFM99-03 trial) with tandem autologous stem cell transplantation (IFM99-04 trial) in high-risk de novo multiple myeloma.

Détails

ID Serval
serval:BIB_FF0F55B506B1
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Prospective comparison of autologous stem cell transplantation followed by dose-reduced allograft (IFM99-03 trial) with tandem autologous stem cell transplantation (IFM99-04 trial) in high-risk de novo multiple myeloma.
Périodique
Blood
Auteur(s)
Garban F., Attal M., Michallet M., Hulin C., Bourhis J.H., Yakoub-Agha I., Lamy T., Marit G., Maloisel F., Berthou C., Dib M., Caillot D., Deprijck B., Ketterer N., Harousseau J.L., Sotto J.J., Moreau P.
ISSN
0006-4971 (Print)
ISSN-L
0006-4971
Statut éditorial
Publié
Date de publication
2006
Volume
107
Numéro
9
Pages
3474-3480
Langue
anglais
Notes
Publication types: Comparative Study ; Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
The Intergroupe Francophone du Myélome (IFM) initiated 2 trials in 1999 to study patients with high-risk (beta2-microglobulin level greater than 3 mg/L and chromosome 13 deletion at diagnosis) de novo multiple myeloma. In both protocols, the induction regimen consisted of vincristine, doxorubicin, and dexamethasone (VAD) followed by first autologous stem cell transplantation (ASCT) prepared by melphalan 200 mg/m(2). Patients with an HLA-identical sibling donor were subsequently treated with dose-reduced allogeneic stem cell transplantation (IFM99-03 trial), and patients without an HLA-identical sibling donor were randomly assigned to undergo second ASCT prepared by melphalan 220 mg/m(2) and 160 mg dexamethasone with or without anti-IL-6 monoclonal antibody (IFM99-04 protocol). Two hundred eighty-four patients-65 in the IFM99-03 trial and 219 in the IFM99-04 trial-were prospectively treated and received at least one course of VAD. On an intent-to-treat basis, overall survival (OS) and event-free survival (EFS) did not differ significantly in the studies (medians 35 and 25 months in the IFM99-03 trial vs 41 and 30 months in the IFM99-04 trial, respectively). With a median follow-up time of 24 months, the EFS of the 166 patients randomly assigned in the tandem ASCT protocol was similar to the EFS of the 46 patients who underwent the entire IFM99-03 program (median, 35 vs 31.7 months), with a trend for a better OS in patients treated with tandem ASCT (median, 47.2 vs 35 months; P = .07). In patients with high-risk de novo MM, the combination of ASCT followed by dose-reduced allogeneic transplantation was not superior to tandem dose-intensified, melphalan-based ASCT.
Mots-clé
Adult, Aged, Disease-Free Survival, Female, Graft Survival, Graft vs Host Disease/etiology, HLA Antigens, Hematopoietic Stem Cell Transplantation/adverse effects, Humans, Lymphocyte Transfusion, Male, Middle Aged, Multiple Myeloma/mortality, Multiple Myeloma/therapy, Prospective Studies, Siblings, Survival Rate, Tissue Donors, Transplantation, Autologous, Transplantation, Homologous
Pubmed
Web of science
Open Access
Oui
Création de la notice
25/04/2008 9:24
Dernière modification de la notice
20/08/2019 17:29
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