1. Superiority of thalidomide and dexamethasone over vincristine-doxorubicindexamethasone (VAD) as primary therapy in preparation for autologous transplantation for multiple myeloma
- Author
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CAVO, MICHELE, ZAMAGNI, ELENA, TOSI, PATRIZIA, TACCHETTI, PAOLA, CELLINI, CLAUDIA, CANGINI D, DE VIVO, ANTONIO, TESTONI, NICOLETTA, NICCI, CHIARA, TERRAGNA, CAROLINA, GRAFONE T, PERRONE, GIULIA, CECCOLINI, MICHELA, TURA, SANTE, BACCARANI, MICHELE, BOLOGNA STUDY, CAVO M, ZAMAGNI E, TOSI P, TACCHETTI P, CELLINI C, CANGINI D, DE VIVO A, TESTONI N, NICCI C, TERRAGNA C, GRAFONE T, PERRONE G, CECCOLINI M, TURA S, BACCARANI M., and BOLOGNA STUDY.
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Immunology ,VAD Regimen ,Anti-Inflammatory Agents ,Hematopoietic stem cell transplantation ,Biochemistry ,Gastroenterology ,Dexamethasone ,MULTIPLE MYELOMA ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Autologous transplantation ,Multiple myeloma ,Retrospective Studies ,Chemotherapy ,business.industry ,Hematopoietic Stem Cell Transplantation ,Cell Biology ,Hematology ,Middle Aged ,medicine.disease ,Thalidomide ,Surgery ,Transplantation ,Doxorubicin ,Vincristine ,Case-Control Studies ,business ,Immunosuppressive Agents ,medicine.drug - Abstract
The aim of the present study was to compare thalidomide-dexamethasone (Thal-Dex) and vincristine-doxorubicin-dexamethasone (VAD) as primary therapy in preparation for autologous peripheral blood stem-cell (PBSC) transplantation for multiple myeloma (MM). For this purpose, we performed a retrospective matched case-control analysis of 200 patients who entered 2 consecutive studies from 1996 to 2004 and received Thal-Dex (n = 100) or VAD (n = 100) administered for 4 months before collection of PBSCs and autologous transplantation. Matching criteria included age, clinical stage, and serum β2-microglobulin levels. In comparison with VAD, Thal-Dex resulted in a significantly higher response rate (52% versus 76%, respectively; P < .001) and effected more profound reduction in myeloma cell mass of both immunoglobulin G (IgG; P = .02) and IgA (P = .03) type. More frequent toxicities included nonfatal deep vein thrombosis with Thal-Dex (15%) and granulocytopenia with VAD (12%). In each of the 2 treatment groups, 91% of patients proceeded to PBSC mobilization. The median number of collected CD34+ cells was 7.85 × 106/kg in the Thal-Dex group and 10.5 × 106/kg in the control group. Thal-Dex may be considered an effective and relatively well-tolerated oral alternative to the more complex VAD regimen as front-line therapy for MM patients who are candidates for subsequent autologous transplantation.
- Published
- 2005
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