Impact of high-risk cytogenetics and achievement of molecular remission on long-term freedom from disease after autologous-allogeneic tandem transplantation in patients with multiple myeloma.
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Impact of high-risk cytogenetics and achievement of molecular remission on long-term freedom from disease after autologous-allogeneic tandem transplantation in patients with multiple myeloma. / Kröger, Nicolaus-Martin; Badbaran, Anita; Zabelina, Tatiana; Ayuketang, Francis Ayuk; Wolschke, Christine; Alchalby, Haefaa; Klyuchnikov, Evgeny; Atanackovic, Djordje; Schilling, Georgia; Hansen, Timon; Schwarz, Sabine; Heinzelmann, Marion; Zeschke, Silke; Bacher, Ulrike; Stübig, Thomas; Fehse, Boris; Zander, Axel R.
In: BIOL BLOOD MARROW TR, Vol. 19, No. 3, 3, 2013, p. 398-404.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Impact of high-risk cytogenetics and achievement of molecular remission on long-term freedom from disease after autologous-allogeneic tandem transplantation in patients with multiple myeloma.
AU - Kröger, Nicolaus-Martin
AU - Badbaran, Anita
AU - Zabelina, Tatiana
AU - Ayuketang, Francis Ayuk
AU - Wolschke, Christine
AU - Alchalby, Haefaa
AU - Klyuchnikov, Evgeny
AU - Atanackovic, Djordje
AU - Schilling, Georgia
AU - Hansen, Timon
AU - Schwarz, Sabine
AU - Heinzelmann, Marion
AU - Zeschke, Silke
AU - Bacher, Ulrike
AU - Stübig, Thomas
AU - Fehse, Boris
AU - Zander, Axel R
N1 - Copyright © 2013. Published by Elsevier Inc.
PY - 2013
Y1 - 2013
N2 - Within a prospective protocol, the incidence and impact of achievement of molecular remission (mCR) and high-risk cytogenetics was investigated in 73 patients with multiple myeloma (MM) after autologous (auto)-allogeneic (allo) tandem stem cell transplantation (SCT). After induction chemotherapy, patients received melphalan 200 mg/m(2) before undergoing auto-SCT, followed 3 months later by melphalan 140 mg/m(2) and fludarabine 180 mg/m(2) before allo-SCT. Sixteen patients had high-risk cytogenetic features, defined by positive FISH for del(17p13) and/or t(4;14). Overall, 66% of the patients achieved CR or near-CR, and 41% achieved mCR, which was sustained negative (at least 4 consecutive samples negative) in 15 patients (21%), with no significant difference in incidence between the patients with high-risk cytogenetics and others (P = .70). After a median follow-up of 6 years, overall 5-year progression-free survival was 29%, with no significant difference between del 17p13/t(4;14)-harboring patients and others (24% versus 30%; P = .70). The 5-year progression-free survival differed substantially according to the achieved remission: 17% for partial remission, 41% for CR, 57% for mCR, and 85% for sustained mCR. These results suggest that auto-allo tandem SCT may overcome the negative prognostic effect of del(17p13) and/or t(4;14) and that achievement of molecular remission resulted in long-term freedom from disease.
AB - Within a prospective protocol, the incidence and impact of achievement of molecular remission (mCR) and high-risk cytogenetics was investigated in 73 patients with multiple myeloma (MM) after autologous (auto)-allogeneic (allo) tandem stem cell transplantation (SCT). After induction chemotherapy, patients received melphalan 200 mg/m(2) before undergoing auto-SCT, followed 3 months later by melphalan 140 mg/m(2) and fludarabine 180 mg/m(2) before allo-SCT. Sixteen patients had high-risk cytogenetic features, defined by positive FISH for del(17p13) and/or t(4;14). Overall, 66% of the patients achieved CR or near-CR, and 41% achieved mCR, which was sustained negative (at least 4 consecutive samples negative) in 15 patients (21%), with no significant difference in incidence between the patients with high-risk cytogenetics and others (P = .70). After a median follow-up of 6 years, overall 5-year progression-free survival was 29%, with no significant difference between del 17p13/t(4;14)-harboring patients and others (24% versus 30%; P = .70). The 5-year progression-free survival differed substantially according to the achieved remission: 17% for partial remission, 41% for CR, 57% for mCR, and 85% for sustained mCR. These results suggest that auto-allo tandem SCT may overcome the negative prognostic effect of del(17p13) and/or t(4;14) and that achievement of molecular remission resulted in long-term freedom from disease.
KW - Adult
KW - Cytogenetic Analysis
KW - Disease-Free Survival
KW - Female
KW - Hematopoietic Stem Cell Transplantation
KW - Humans
KW - Male
KW - Melphalan
KW - Middle Aged
KW - Multiple Myeloma
KW - Myeloablative Agonists
KW - Prognosis
KW - Prospective Studies
KW - Remission Induction
KW - Translocation, Genetic
KW - Transplantation Conditioning
KW - Transplantation, Autologous
KW - Transplantation, Homologous
KW - Treatment Outcome
KW - Vidarabine
U2 - 10.1016/j.bbmt.2012.10.008
DO - 10.1016/j.bbmt.2012.10.008
M3 - SCORING: Journal article
C2 - 23078786
VL - 19
SP - 398
EP - 404
JO - BIOL BLOOD MARROW TR
JF - BIOL BLOOD MARROW TR
SN - 1083-8791
IS - 3
M1 - 3
ER -