Article open access publication

Salvage bortezomib–dexamethasone and high-dose melphalan (HDM) and autologous stem cell support (ASCT) in myeloma patients at first relapse after HDM with ASCT. A phase-2 trial

Bone Marrow Transplantation, Springer Nature, ISSN 0268-3369

Volume 50, 10, 2015

DOI:10.1038/bmt.2015.125, Dimensions: pub.1005790139, PMC: PMC4598614, PMID: 26121108,

Authors

Gimsing, P * (1)
Dahl, T G (5)
Linder, O (9)
Lindås, R (10)
Lenhoff, S (11)

* Corresponding author

Affiliations

Organisations

  1. (1) Department of Hematology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
  2. (2) Department of Hematology, St. Olavs University Hospital, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
  3. (3) Department of Hematology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
  4. (4) Aarhus University Hospital, grid.154185.c, Central Denmark Region
  5. (5) Oslo University Hospital, grid.55325.34
  6. (6) Aalborg Hospital, grid.27530.33, North Denmark Region
  7. (7) Herlev Hospital, grid.411900.d, Capital Region
  8. (8) Sahlgrenska University Hospital, grid.1649.a
  9. (9) Örebro University Hospital, grid.412367.5
  10. (10) Haukeland University Hospital, grid.412008.f
  11. (11) Skåne University Hospital, grid.411843.b

Countries

Sweden

Norway

Denmark

Continents

Europe

Description

Until recently, only retrospective studies had been published on salvage high-dose melphalan (HDM) with autologous stem cell 'transplantation' (ASCT). In a prospective, nonrandomized phase-2 study, we treated 53 bortezomib-naïve patients with bortezomib-dexamethasone as induction and bortezomib included in the conditioning regimen along with the HDM. Median progression-free survival (PFS), time to next treatment (TNT) and overall survival (OS) after start of reinduction therapy were 21.6, 22.8 and 46.6 months, respectively. For 49 patients who completed salvage bortezomib-HDM(II) with ASCT, there was no significant difference of PFS and TNT after HDM (II) compared with after the initial HDM(I), and thus patients were their own controls (PFS (I: 20.1 vs II: 19.3 months (P=0.8)) or TNT (I: 24.4 vs II: 20.7 months (P=0.8)). No significant differences in the response rates after salvage ASCT compared with the initial ASCT. Bortezomib-HDM conditioning combo was feasible, and toxicity was as expected for patients treated with bortezomib and ASCT. In conclusion, in bortezomib-naïve patients treated at first relapse with salvage ASCT including bortezomib, PSF and TNT did not differ significantly from initial ASCT and median OS was almost 5.5 years with acceptable toxicity. A recent prospective randomized study confirms salvage ASCT to be an effective treatment.

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2015: Unused

Research area: Medicine

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2015: Level 1

Research area: Medicine

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Times Cited: 10

Field Citation Ratio (FCR): 2.21

Relative Citation ratio (RCR): 0.41

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