High-dose chemotherapy followed by autologous stem cell transplant for multiple myeloma: Predictors of long-term outcome
Background & objectives: Survival of patients with multiple myeloma (MM) has improved in the past two decades following use of novel agents and autologous stem cell transplantation. To determine predictors of long-term outcome, data of MM patients who underwent autologous stem cell transplantati...
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| Veröffentlicht in: | Indian journal of medical research (New Delhi, India : 1994) India : 1994), 2019-06, Vol.149 (6), p.730-739 |
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| container_title | Indian journal of medical research (New Delhi, India : 1994) |
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| creator | Kumar, Lalit Ramavath, Dev Kataria, Babita Tiwari, Akash Raj, Abhishek Chellapuram, Santosh Mookerjee, Anjali Sahoo, Ranjit Malik, Prabhat Sharma, Atul Gupta, Ritu Sharma, Om Biswas, Ahitagni Kumar, Rakesh Thulkar, Sanjay |
| description | Background & objectives: Survival of patients with multiple myeloma (MM) has improved in the past two decades following use of novel agents and autologous stem cell transplantation. To determine predictors of long-term outcome, data of MM patients who underwent autologous stem cell transplantation (ASCT) at a tertiary care centre in north India were retrospectively analyzed.
Methods: Between 1995 and 2016, 349 MM patients underwent ASCT. Patients' median age was 52 yr, ranging from 29 to 68 yr, 68.2 per cent were males. Thirty three per cent patients had international staging system (ISS) Stage III and 68.5 per cent had received novel agents-based induction. High-dose melphalan (200 mg/m2) was used for conditioning; patients with renal insufficiency (estimated glomerular filtration rate |
| doi_str_mv | 10.4103/ijmr.IJMR_1593_18 |
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| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6755776</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A598499341</galeid><sourcerecordid>A598499341</sourcerecordid><originalsourceid>FETCH-LOGICAL-c564e-b0bbb99d54cd5436140f213e641bd67e41cd1b1d99e9d4fe53509249084306a63</originalsourceid><addsrcrecordid>eNp1kkFv1DAQhXMA0VL4AVyQJS5cstixncQckKqq0KJWIARny3Emu9namcVOWPbf42jb1RaBLMuS_b1nz_hl2StGF4JR_q5f-7C4_nz7TTOpuGb1k-yUqorlUrHyJHse45pSpopKPctOOBOqlIU8zX5f9ctV3mIEYlfgcVxBMJsd6dA53EJLmh0x04gOlzhFEkfwxIJzZAxmiBtnhjGxgfjJjf3GAfE7cOjNe_I1QNvbEUMk2BGHwzIfIXiC02jRw4vsaWdchJf361n24-Pl94ur_ObLp-uL85vcylJA3tCmaZRqpbBp8pIJ2hWMQylY05YVCGZb1rBWKVCt6EBySVUhFK0Fp6Up-Vn2Ye-7mRoPrYUhvdzpTei9CTuNptePT4Z-pZf4S5eVlFU1G7y9Nwj4c4I4at_HuQVmgNQSXRR1JTkva5nQN3-ha5zCkMqbKVHXlRJH1NI40P3QYbrXzqb6XKpaKMUFS9TiH1QaLfje4gBdn_YfCdheYAPGGKA71MioniOi54jo44gkzevj5hwUD_lIwO0e2KJLvxfv3LSFoBN7N-D2_8664lQfoqUfosX_AJNL16Q</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2284887945</pqid></control><display><type>article</type><title>High-dose chemotherapy followed by autologous stem cell transplant for multiple myeloma: Predictors of long-term outcome</title><source>MEDLINE</source><source>PubMed Central</source><source>PubMed Central Open Access</source><creator>Kumar, Lalit ; Ramavath, Dev ; Kataria, Babita ; Tiwari, Akash ; Raj, Abhishek ; Chellapuram, Santosh ; Mookerjee, Anjali ; Sahoo, Ranjit ; Malik, Prabhat ; Sharma, Atul ; Gupta, Ritu ; Sharma, Om ; Biswas, Ahitagni ; Kumar, Rakesh ; Thulkar, Sanjay</creator><creatorcontrib>Kumar, Lalit ; Ramavath, Dev ; Kataria, Babita ; Tiwari, Akash ; Raj, Abhishek ; Chellapuram, Santosh ; Mookerjee, Anjali ; Sahoo, Ranjit ; Malik, Prabhat ; Sharma, Atul ; Gupta, Ritu ; Sharma, Om ; Biswas, Ahitagni ; Kumar, Rakesh ; Thulkar, Sanjay ; for AIIMS Myeloma Group</creatorcontrib><description>Background & objectives: Survival of patients with multiple myeloma (MM) has improved in the past two decades following use of novel agents and autologous stem cell transplantation. To determine predictors of long-term outcome, data of MM patients who underwent autologous stem cell transplantation (ASCT) at a tertiary care centre in north India were retrospectively analyzed.
Methods: Between 1995 and 2016, 349 MM patients underwent ASCT. Patients' median age was 52 yr, ranging from 29 to 68 yr, 68.2 per cent were males. Thirty three per cent patients had international staging system (ISS) Stage III and 68.5 per cent had received novel agents-based induction. High-dose melphalan (200 mg/m2) was used for conditioning; patients with renal insufficiency (estimated glomerular filtration rate <40 ml/min) received melphalan 140-150 mg/m2.
Results: Post-transplant, 317 of 349 (90.8%) patients responded; complete [complete response (CR)] −213 (61%)], very good partial response (VGPR) −62 (17.8%) and PR in 42 (12%)]. Induction with novel agents, pre-transplant chemosensitive disease, transplant in first remission and serum albumin (≥3.5 g/dl) were predictors of significant response. At a median follow up of 73 months, median overall survival (OS) was 90 months [95% confidence interval (CI) 70.8-109.2], and progression-free survival (PFS) was 41 months (95% CI 33.0-49.0). On multivariate analysis, achievement of CR post-transplant, transplant in first remission, ISS Stages I and II (vs. III), absence of extramedullary disease and serum albumin ≥3.5 g/dl were predictors of prolonged OS. For PFS, achievement of post-transplant CR and transplant in first remission were predictors of superior outcome.
Interpretation & conclusions: Treatment with novel agents, achievement of complete remission post-transplant, ISS Stages I and II, absence of extramedullary disease and transplant in first remission were predictors of long-term survival for patients with MM.</description><identifier>ISSN: 0971-5916</identifier><identifier>DOI: 10.4103/ijmr.IJMR_1593_18</identifier><identifier>PMID: 31496525</identifier><language>eng</language><publisher>India: Wolters Kluwer India Pvt. Ltd</publisher><subject>Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; Care and treatment ; Chemotherapy ; Diagnosis ; Disease-Free Survival ; Dosage and administration ; Dose-Response Relationship, Drug ; Drug dosages ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; India - epidemiology ; Male ; Medical prognosis ; Melphalan - administration & dosage ; Methods ; Middle Aged ; Multiple myeloma ; Multiple Myeloma - pathology ; Multiple Myeloma - therapy ; Original ; Patient outcomes ; Remission Induction ; Response rates ; Stem cell transplantation ; Stem cells ; Studies ; Transplantation, Autologous ; Transplants & implants ; Treatment Outcome</subject><ispartof>Indian journal of medical research (New Delhi, India : 1994), 2019-06, Vol.149 (6), p.730-739</ispartof><rights>COPYRIGHT 2019 Medknow Publications and Media Pvt. Ltd.</rights><rights>2019. This work is published under https://creativecommons.org/licenses/by-nc-sa/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright: © 2019 Indian Journal of Medical Research 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c564e-b0bbb99d54cd5436140f213e641bd67e41cd1b1d99e9d4fe53509249084306a63</citedby><cites>FETCH-LOGICAL-c564e-b0bbb99d54cd5436140f213e641bd67e41cd1b1d99e9d4fe53509249084306a63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6755776/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6755776/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31496525$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kumar, Lalit</creatorcontrib><creatorcontrib>Ramavath, Dev</creatorcontrib><creatorcontrib>Kataria, Babita</creatorcontrib><creatorcontrib>Tiwari, Akash</creatorcontrib><creatorcontrib>Raj, Abhishek</creatorcontrib><creatorcontrib>Chellapuram, Santosh</creatorcontrib><creatorcontrib>Mookerjee, Anjali</creatorcontrib><creatorcontrib>Sahoo, Ranjit</creatorcontrib><creatorcontrib>Malik, Prabhat</creatorcontrib><creatorcontrib>Sharma, Atul</creatorcontrib><creatorcontrib>Gupta, Ritu</creatorcontrib><creatorcontrib>Sharma, Om</creatorcontrib><creatorcontrib>Biswas, Ahitagni</creatorcontrib><creatorcontrib>Kumar, Rakesh</creatorcontrib><creatorcontrib>Thulkar, Sanjay</creatorcontrib><creatorcontrib>for AIIMS Myeloma Group</creatorcontrib><title>High-dose chemotherapy followed by autologous stem cell transplant for multiple myeloma: Predictors of long-term outcome</title><title>Indian journal of medical research (New Delhi, India : 1994)</title><addtitle>Indian J Med Res</addtitle><description>Background & objectives: Survival of patients with multiple myeloma (MM) has improved in the past two decades following use of novel agents and autologous stem cell transplantation. To determine predictors of long-term outcome, data of MM patients who underwent autologous stem cell transplantation (ASCT) at a tertiary care centre in north India were retrospectively analyzed.
Methods: Between 1995 and 2016, 349 MM patients underwent ASCT. Patients' median age was 52 yr, ranging from 29 to 68 yr, 68.2 per cent were males. Thirty three per cent patients had international staging system (ISS) Stage III and 68.5 per cent had received novel agents-based induction. High-dose melphalan (200 mg/m2) was used for conditioning; patients with renal insufficiency (estimated glomerular filtration rate <40 ml/min) received melphalan 140-150 mg/m2.
Results: Post-transplant, 317 of 349 (90.8%) patients responded; complete [complete response (CR)] −213 (61%)], very good partial response (VGPR) −62 (17.8%) and PR in 42 (12%)]. Induction with novel agents, pre-transplant chemosensitive disease, transplant in first remission and serum albumin (≥3.5 g/dl) were predictors of significant response. At a median follow up of 73 months, median overall survival (OS) was 90 months [95% confidence interval (CI) 70.8-109.2], and progression-free survival (PFS) was 41 months (95% CI 33.0-49.0). On multivariate analysis, achievement of CR post-transplant, transplant in first remission, ISS Stages I and II (vs. III), absence of extramedullary disease and serum albumin ≥3.5 g/dl were predictors of prolonged OS. For PFS, achievement of post-transplant CR and transplant in first remission were predictors of superior outcome.
Interpretation & conclusions: Treatment with novel agents, achievement of complete remission post-transplant, ISS Stages I and II, absence of extramedullary disease and transplant in first remission were predictors of long-term survival for patients with MM.</description><subject>Adult</subject><subject>Aged</subject><subject>Antineoplastic Combined Chemotherapy Protocols</subject><subject>Care and treatment</subject><subject>Chemotherapy</subject><subject>Diagnosis</subject><subject>Disease-Free Survival</subject><subject>Dosage and administration</subject><subject>Dose-Response Relationship, Drug</subject><subject>Drug dosages</subject><subject>Female</subject><subject>Hematopoietic Stem Cell Transplantation</subject><subject>Humans</subject><subject>India - epidemiology</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Melphalan - administration & dosage</subject><subject>Methods</subject><subject>Middle Aged</subject><subject>Multiple myeloma</subject><subject>Multiple Myeloma - pathology</subject><subject>Multiple Myeloma - therapy</subject><subject>Original</subject><subject>Patient outcomes</subject><subject>Remission Induction</subject><subject>Response rates</subject><subject>Stem cell transplantation</subject><subject>Stem cells</subject><subject>Studies</subject><subject>Transplantation, Autologous</subject><subject>Transplants & implants</subject><subject>Treatment Outcome</subject><issn>0971-5916</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp1kkFv1DAQhXMA0VL4AVyQJS5cstixncQckKqq0KJWIARny3Emu9namcVOWPbf42jb1RaBLMuS_b1nz_hl2StGF4JR_q5f-7C4_nz7TTOpuGb1k-yUqorlUrHyJHse45pSpopKPctOOBOqlIU8zX5f9ctV3mIEYlfgcVxBMJsd6dA53EJLmh0x04gOlzhFEkfwxIJzZAxmiBtnhjGxgfjJjf3GAfE7cOjNe_I1QNvbEUMk2BGHwzIfIXiC02jRw4vsaWdchJf361n24-Pl94ur_ObLp-uL85vcylJA3tCmaZRqpbBp8pIJ2hWMQylY05YVCGZb1rBWKVCt6EBySVUhFK0Fp6Up-Vn2Ye-7mRoPrYUhvdzpTei9CTuNptePT4Z-pZf4S5eVlFU1G7y9Nwj4c4I4at_HuQVmgNQSXRR1JTkva5nQN3-ha5zCkMqbKVHXlRJH1NI40P3QYbrXzqb6XKpaKMUFS9TiH1QaLfje4gBdn_YfCdheYAPGGKA71MioniOi54jo44gkzevj5hwUD_lIwO0e2KJLvxfv3LSFoBN7N-D2_8664lQfoqUfosX_AJNL16Q</recordid><startdate>20190601</startdate><enddate>20190601</enddate><creator>Kumar, Lalit</creator><creator>Ramavath, Dev</creator><creator>Kataria, Babita</creator><creator>Tiwari, Akash</creator><creator>Raj, Abhishek</creator><creator>Chellapuram, Santosh</creator><creator>Mookerjee, Anjali</creator><creator>Sahoo, Ranjit</creator><creator>Malik, Prabhat</creator><creator>Sharma, Atul</creator><creator>Gupta, Ritu</creator><creator>Sharma, Om</creator><creator>Biswas, Ahitagni</creator><creator>Kumar, Rakesh</creator><creator>Thulkar, Sanjay</creator><general>Wolters Kluwer India Pvt. Ltd</general><general>Medknow Publications and Media Pvt. Ltd</general><general>Scientific Scholar</general><general>Wolters Kluwer - Medknow</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M2P</scope><scope>MBDVC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20190601</creationdate><title>High-dose chemotherapy followed by autologous stem cell transplant for multiple myeloma: Predictors of long-term outcome</title><author>Kumar, Lalit ; Ramavath, Dev ; Kataria, Babita ; Tiwari, Akash ; Raj, Abhishek ; Chellapuram, Santosh ; Mookerjee, Anjali ; Sahoo, Ranjit ; Malik, Prabhat ; Sharma, Atul ; Gupta, Ritu ; Sharma, Om ; Biswas, Ahitagni ; Kumar, Rakesh ; Thulkar, Sanjay</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c564e-b0bbb99d54cd5436140f213e641bd67e41cd1b1d99e9d4fe53509249084306a63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Antineoplastic Combined Chemotherapy Protocols</topic><topic>Care and treatment</topic><topic>Chemotherapy</topic><topic>Diagnosis</topic><topic>Disease-Free Survival</topic><topic>Dosage and administration</topic><topic>Dose-Response Relationship, Drug</topic><topic>Drug dosages</topic><topic>Female</topic><topic>Hematopoietic Stem Cell Transplantation</topic><topic>Humans</topic><topic>India - epidemiology</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Melphalan - administration & dosage</topic><topic>Methods</topic><topic>Middle Aged</topic><topic>Multiple myeloma</topic><topic>Multiple Myeloma - pathology</topic><topic>Multiple Myeloma - therapy</topic><topic>Original</topic><topic>Patient outcomes</topic><topic>Remission Induction</topic><topic>Response rates</topic><topic>Stem cell transplantation</topic><topic>Stem cells</topic><topic>Studies</topic><topic>Transplantation, Autologous</topic><topic>Transplants & implants</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kumar, Lalit</creatorcontrib><creatorcontrib>Ramavath, Dev</creatorcontrib><creatorcontrib>Kataria, Babita</creatorcontrib><creatorcontrib>Tiwari, Akash</creatorcontrib><creatorcontrib>Raj, Abhishek</creatorcontrib><creatorcontrib>Chellapuram, Santosh</creatorcontrib><creatorcontrib>Mookerjee, Anjali</creatorcontrib><creatorcontrib>Sahoo, Ranjit</creatorcontrib><creatorcontrib>Malik, Prabhat</creatorcontrib><creatorcontrib>Sharma, Atul</creatorcontrib><creatorcontrib>Gupta, Ritu</creatorcontrib><creatorcontrib>Sharma, Om</creatorcontrib><creatorcontrib>Biswas, Ahitagni</creatorcontrib><creatorcontrib>Kumar, Rakesh</creatorcontrib><creatorcontrib>Thulkar, Sanjay</creatorcontrib><creatorcontrib>for AIIMS Myeloma Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Research Library (Corporate)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Indian journal of medical research (New Delhi, India : 1994)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kumar, Lalit</au><au>Ramavath, Dev</au><au>Kataria, Babita</au><au>Tiwari, Akash</au><au>Raj, Abhishek</au><au>Chellapuram, Santosh</au><au>Mookerjee, Anjali</au><au>Sahoo, Ranjit</au><au>Malik, Prabhat</au><au>Sharma, Atul</au><au>Gupta, Ritu</au><au>Sharma, Om</au><au>Biswas, Ahitagni</au><au>Kumar, Rakesh</au><au>Thulkar, Sanjay</au><aucorp>for AIIMS Myeloma Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>High-dose chemotherapy followed by autologous stem cell transplant for multiple myeloma: Predictors of long-term outcome</atitle><jtitle>Indian journal of medical research (New Delhi, India : 1994)</jtitle><addtitle>Indian J Med Res</addtitle><date>2019-06-01</date><risdate>2019</risdate><volume>149</volume><issue>6</issue><spage>730</spage><epage>739</epage><pages>730-739</pages><issn>0971-5916</issn><abstract>Background & objectives: Survival of patients with multiple myeloma (MM) has improved in the past two decades following use of novel agents and autologous stem cell transplantation. To determine predictors of long-term outcome, data of MM patients who underwent autologous stem cell transplantation (ASCT) at a tertiary care centre in north India were retrospectively analyzed.
Methods: Between 1995 and 2016, 349 MM patients underwent ASCT. Patients' median age was 52 yr, ranging from 29 to 68 yr, 68.2 per cent were males. Thirty three per cent patients had international staging system (ISS) Stage III and 68.5 per cent had received novel agents-based induction. High-dose melphalan (200 mg/m2) was used for conditioning; patients with renal insufficiency (estimated glomerular filtration rate <40 ml/min) received melphalan 140-150 mg/m2.
Results: Post-transplant, 317 of 349 (90.8%) patients responded; complete [complete response (CR)] −213 (61%)], very good partial response (VGPR) −62 (17.8%) and PR in 42 (12%)]. Induction with novel agents, pre-transplant chemosensitive disease, transplant in first remission and serum albumin (≥3.5 g/dl) were predictors of significant response. At a median follow up of 73 months, median overall survival (OS) was 90 months [95% confidence interval (CI) 70.8-109.2], and progression-free survival (PFS) was 41 months (95% CI 33.0-49.0). On multivariate analysis, achievement of CR post-transplant, transplant in first remission, ISS Stages I and II (vs. III), absence of extramedullary disease and serum albumin ≥3.5 g/dl were predictors of prolonged OS. For PFS, achievement of post-transplant CR and transplant in first remission were predictors of superior outcome.
Interpretation & conclusions: Treatment with novel agents, achievement of complete remission post-transplant, ISS Stages I and II, absence of extramedullary disease and transplant in first remission were predictors of long-term survival for patients with MM.</abstract><cop>India</cop><pub>Wolters Kluwer India Pvt. Ltd</pub><pmid>31496525</pmid><doi>10.4103/ijmr.IJMR_1593_18</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Indian journal of medical research (New Delhi, India : 1994), 2019-06, Vol.149 (6), p.730-739 |
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| subjects | Adult Aged Antineoplastic Combined Chemotherapy Protocols Care and treatment Chemotherapy Diagnosis Disease-Free Survival Dosage and administration Dose-Response Relationship, Drug Drug dosages Female Hematopoietic Stem Cell Transplantation Humans India - epidemiology Male Medical prognosis Melphalan - administration & dosage Methods Middle Aged Multiple myeloma Multiple Myeloma - pathology Multiple Myeloma - therapy Original Patient outcomes Remission Induction Response rates Stem cell transplantation Stem cells Studies Transplantation, Autologous Transplants & implants Treatment Outcome |
| title | High-dose chemotherapy followed by autologous stem cell transplant for multiple myeloma: Predictors of long-term outcome |
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