Achievement of at least very good partial response is a simple and robust prognostic factor in patients with multiple myeloma treated with high-dose therapy: long-term analysis of the IFM 99-02 and 99-04 Trials.

Détails

ID Serval
serval:BIB_7FA88E5C0594
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Achievement of at least very good partial response is a simple and robust prognostic factor in patients with multiple myeloma treated with high-dose therapy: long-term analysis of the IFM 99-02 and 99-04 Trials.
Périodique
Journal of Clinical Oncology
Auteur(s)
Harousseau J.L., Avet-Loiseau H., Attal M., Charbonnel C., Garban F., Hulin C., Michallet M., Facon T., Garderet L., Marit G., Ketterer N., Lamy T., Voillat L., Guilhot F., Doyen C., Mathiot C., Moreau P.
ISSN
1527-7755[electronic], 0732-183X[linking]
Statut éditorial
Publié
Date de publication
10/2009
Volume
27
Numéro
34
Pages
5720-5726
Langue
anglais
Résumé
PURPOSE: The prognostic impact of complete response (CR) achievement in multiple myeloma (MM) has been shown mostly in the context of autologous stem-cell transplantation. Other levels of response have been defined because, even with high-dose therapy, CR is a relatively rare event. The purpose of this study was to analyze the prognostic impact of very good partial response (VGPR) in patients treated with high-dose therapy. PATIENTS AND METHODS: All patients were included in the Intergroupe Francophone du Myelome 99-02 and 99-04 trials and treated with vincristine, doxorubicin, and dexamethasone (VAD) induction therapy followed by double autologous stem-cell transplantation (ASCT). Best post-ASCT response assessment was available for 802 patients. RESULTS: With a median follow-up of 67 months, median event-free survival (EFS) and 5-year EFS were 42 months and 34%, respectively, for 405 patients who achieved at least VGPR after ASCT versus 32 months and 26% in 288 patients who achieved only partial remission (P = .005). Five-year overall survival (OS) was significantly superior in patients achieving at least VGPR (74% v 61% P = .0017). In multivariate analysis, achievement of less than VGPR was an independent factor predicting shorter EFS and OS. Response to VAD had no impact on EFS and OS. The impact of VGPR achievement on EFS and OS was significant in patients with International Staging System stages 2 to 3 and for patients with poor-risk cytogenetics t(4;14) or del(17p). CONCLUSION: In the context of ASCT, achievement of at least VGPR is a simple prognostic factor that has importance in intermediate and high-risk MM and can be informative in more patients than CR.
Mots-clé
Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Combined Modality Therapy, Dexamethasone/administration & dosage, Disease-Free Survival, Doxorubicin/administration & dosage, Hematopoietic Stem Cell Transplantation, Humans, Middle Aged, Multiple Myeloma/drug therapy, Multiple Myeloma/mortality, Prognosis, Remission Induction, Survival Rate, Transplantation, Autologous, Vincristine/administration & dosage
Pubmed
Web of science
Création de la notice
21/10/2009 9:32
Dernière modification de la notice
03/03/2018 18:43
Données d'usage