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1. Will Molecular Biology Contribute to Refine Prognosis and to Select Treatment?

Author

Zaccaria, A, Martinelli, G, Buzzi, M, Farabegoli, P, Saglio, G, Guerrasio, A, Bernabei, P, Santini, V, Pellicci, P, Mencarelli, A, Coco, F, Diverio, D, Rambaldi, A, Santoro, A, Tura, S, Russo, D, Zuffa, E, Fanin, R, Patriarca, F, Fiacchini, M, Baccarani, M, Testoni, N, Zamagni, M, Montefusco, E, Alimena, G, Meloni, G, Mandelli, F, Damiani, D, Michieli, M, Criscuolo, D, Fowst, C, Holdener, E, Specchia, G, Liso, V, Morra, E, Bernasconi, C, Demilio, A, Battista, R, Ditucci, A, Broccia, G, Maiolino, I, Caronia, F, Luciano, L, Rotoli, B, Leoni, P, Danieli, G, Bodenizza, C, Carotenuto, M, Rotondo, S, Nosari, A, Decataldo, F, Montuoro, A, Delaurenzi, A, Camillo, S, Liberati, A, Grignani, F, Tabilio, A, Martelli, M, Barbui, T, Leoni, F, Ciolli, S, Ronca, F, Nobile, F, Paolino, F, Resegotti, L, Papineschi, F, Spremolla, G, Landolfi, R, Leone, G, Volpe, E, Mangoni, L, Rizzoli, V, Capucci, A, Izzi, T, Scapoli, G, Castoldi, G, Gentilini, I, Coser, P, Gallo, E, Pileri, A, Cantonetti, M, Papa, G, Dini, D, Morandi, S, Bianchini, E, Pinotti, G, Venco, A, Zagonel, V, Pinto, A, Capaldi, A, Giovannelli, E, Pizzuti, M, Ricciuti, F, Ambrosetti, A, Cajozzo, A, Lombardo, M, Torlontano, G, Delfini, C, Lucarelli, G, Girino, M, Ascari, E, Risso, M, Damasio, E, Martino, S, Pardini, S, Longinotti, M, Miraglia, E, Debiase, R, Nardelli, S, Galieni, P, Dispensa, E, Abbadessa, A, Bruzzese, L, Prossomariti, L, Cimino, R, Derosa, C, Gabbas, A, Francesco, S, Gallamini, A, Difrancesco, A, Quaglino, D, Musolino, C, Squadrito, G, Avanzini, P, Gobbi, F, Nuova, A, Emilia, R, Aglietta, M, Camaschella, C, Mazza, M, Guglielmo, P, Cacciola, E, and Monaco, M

Subjects
INTERFERON, CHRONIC MYELOID LEUKEMIA, Cancer Research, PROGNOSIS, biology, Settore MED/06 - Oncologia Medica, business.industry, MOLECULAR BIOLOGY, Breakpoint, Transcript analysis, Hematology, HindIII, Bioinformatics, Restriction site, Text mining, Oncology, Risk index, biology.protein, Medicine, In patient, business, Settore MED/15 - Malattie del Sangue, Southern blot
Abstract

The possible prognostic value of the position of the breakpoint within the M-BCR in patients with Phl+ CML is still being debated. We analyzed the DNA rearrangements and the transcript types of 244 patients and tried to correlate the data obtained with prognostic features, defined according to Sokal's risk index, and with chronic phase and/or survival duration. The exact location of the breakpoint, either 5' or 3' to the Hind III restriction site within the M-BCR was identified. Moreover, the exact M-BCR subregion was also identified. As a whole, 150 pts were rearranged in the 5' part and 94 in the 3' part of the M-BCR. No correlation was observed between the site of rearrangement on the one hand and the Sokal's prognostic index and survival, on the other. Transcript analysis was performed in 130 patients; 59 carried an a2b2 and 69 an a2b3 pattern. Two patients carried both transcripts. Of the patients rearranged in the 5' area, according to Southern blotting, 29.2% showed an a2b3 transcript. Therefore, R...

Published
1993
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2. Confirmation and improvement of Sokal's prognostic classification of Ph+ chronic myeloid leukemia: The value of early evaluation of the course of the disease

Author

G Torlontano, Anna Marina Liberati, E Dini, A Riccardi, B Bizzi, G Sala, G Rosti, L Prossomariti, Giuliana Alimena, L Luciano, Maurizio Martelli, S Rotondo, L Bruzzese, F Grignani, Rizzoli, Maria Cantonetti, E Miraglia, D Damiani, M Monaco, Graziella Pinotti, E Cacciola, G Broccia, Giorgina Specchia, G Spremolla, A Miliani, F Gavosto, Andrea Gallamini, A Delaurenzi, F Paolino, M Carotenuto, M Marangolo, T Diperri, S Nardelli, M Longinotti, C Derosa, F Pasini, G Castoldi, E Ascari, A Ambrosetti, A Difrancesco, S Morandi, A Capucci, F Ciccone, D Dini, P Iacopino, P Ferrini, F Dore, Antonello Pinto, Giuseppe Papa, M Maiolo, P Coser, R Debiase, G Danieli, P Leoni, R Cimino, F Decataldo, E. Dispensa, I Majolino, E Bianchini, R Montuori, C Bodenizza, B Rotoli, Alfonso Zaccaria, I Gentilini, F Leoni, G Perona, C Musolino, A Cajozzo, G Squadrito, R Battista, E Gallo, B Comotti, Luigi Resegotti, R Perricone, Tiziano Barbui, Renato Fanin, P Avanzini, Mauro Fiacchini, T Izzi, M Lombardo, F Buffa, Liso, L Deriu, P Guglielmi, L Mangoni, Enrico Montefusco, G Scapoli, Tura S, D Zamagni, Zagonel, P Foa, G Sparaventi, F Ricciuti, U Diprisco, N Testoni, M Aglietta, M Michieli, F Nobile, Piero Galieni, R Landolfi, A Nosari, Alessandro Pileri, C Bernasconi, A Abbadessa, A Montuoro, G Lucarelli, Eliana Zuffa, Domenico Russo, Franco Mandelli, E Morra, F Gobbi, Michele Baccarani, F Caronia, D Quaglino, F Papineschi, and M Pizzuti

Subjects
Prognostic variable, medicine.medical_specialty, business.industry, Myeloid leukemia, Hematology, General Medicine, Disease, medicine.disease, Surgery, Disease course, Leukemia, Prognostic classification, Internal medicine, Cohort, Medicine, business, Survival rate
Abstract

A simple prognostic classification of Ph+ chronic myeloid leukemia (CML) was proposed in 1984 by an international study Group [23] and is now widely used for clinical purposes. That study was retrospective, and was based on disease features at diagnosis. To test prospectively and to check the value of the classification, and to investigate if additional information on the early course of leukemia can help in refining the prognosis, 505 Ph+, nonblastic and nontransplanted patients first registered between 1984 and 1986 were followed up to June 1990. It was found that the prognostic formulation predicted survival in that series exactly the same way as in the original series (median survival: > 60 months for low-risk patients, 46 months for intermediate-risk patients, and 32 months for high-risk ones). It was also found that several objective or subjective assessments of disease course during the first 8 months after diagnosis were significantly related to survival length within any risk group. This study provides full confirmation of Sokal's international prognostic classification, and shows that the definition of prognosis can be improved some months after diagnosis by taking into account the course of the disease and the response to therapy. These conclusions apply to patients receiving conventional treatment. The course of Ph+ chronic myeloid leukemia (CML) is rigidly programmed to progress to an acute phase, which is called blastic metamorphosis (BM) and which can develop either suddenly (blastic crisis) or by a slow progression (accelerated phase) [7,24,29]. In all recent series, 2-year survival ranged between 65% and 80%, median survival was slightly shorter than 4 years, and the proportion of patients who were still alive after 10 years was less than 10% [24,29]. However, a number of prognostic variables were identified [2,8,9,12,15,16,19,23, 28] and a prognostic formulation that was claborated by an international study [23] was shown to provide a reliable estimate of survival length and is currently used for that purpose. The value of that formulation, and the formulation itself, require periodical controls and revisions. For that purpose, the Italian Cooperative Study Group on CML registered and followed up all CML patients who were first seen between 1984 and 1986. A very preliminary analysis of that cohort of patients has already been performed, but it was limited to the first 2 years after diagnosis [10]. This report extends prior findings, confirming the validity of the formula up to the 5th year after diagnosis, and shows that the definition of prognosis can be significantly improved by taking into account dynamic clements which reflect the course of the disease and the response to conventional treatment during the first 8 months after diagnosis.

Published
1991
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3. INTERFERON ALFA-2A AS COMPARED WITH CONVENTIONAL CHEMOTHERAPY FOR THE TREATMENT OF CHRONIC MYELOID LEUKEMIA

Author

Tura, S, Baccarani, M, Zuffa, E, Russo, D, Zaccaria, A, Fiacchini, M, Testoni, N, Zamagni, M, Martinelli, G, Damiani, D, Michieli, M, Fowst, C, Holdener, E, Specchia, G, Liso, V, Morra, E, Bernasconi, C, Alimena, G, Mandelli, F, Leoni, P, Danieli, G, Nosari, A, Decataldo, F, Majolino, I, Caronia, F, Liberati, A, Grignani, F, Tabilio, A, Martelli, M, Paolino, F, Resegotti, L, Ditucci, A, Broccia, G, Leoni, F, Ciolli, S, Luciano, L, Rotoli, B, Perricone, R, Cajozzo, A, Montuoro, A, Delaurenzi, A, Volpe, E, Demilio, A, Battista, R, Capucci, A, Izzi, T, Scapoli, G, Castoldi, G, Lombardo, M, Torlontano, G, Landolfi, R, Leone, G, Delfini, C, Sparaventi, G, Papineschi, F, Spremolla, G, Risso, M, Marmont, A, Dini, D, Diprisco, U, Mangoni, L, Rizzoli, V, Girino, M, Ascari, E, Bodenizza, C, Carotenuto, M, Difrancesco, A, Quaglino, D, Nardelli, S, Ciccone, F, Miraglia, E, Debiase, R, Gallo, E, Pileri, A, Rambaldi, A, Barbui, T, Morandi, S, Bianchini, E, Derosa, C, Cimino, R, Ronca, F, Nobile, F, Cantonetti, M, Papa, G, Gallamini, A, Buffa, F, Musolino, C, Squadrito, G, Capaldi, A, Giovannelli, E, Pinotti, G, Venco, A, Zagonel, V, Pinto, A, Gentilini, I, Coser, P, Guglielmo, P, Cacciola, E, Pizzuti, M, Ricciuti, F, Fanin, R, Criscuolo, D, and Montefusco, E

Subjects
Settore MED/06 - Oncologia Medica, CHRONIC MYELOGENOUS LEUKEMIA, BONE-MARROW TRANSPLANTATION, THERAPY, Settore MED/15 - Malattie del Sangue
Published
1994

4. EVALUATING SURVIVAL AFTER ALLOGENEIC BONE-MARROW TRANSPLANT FOR CHRONIC MYELOID-LEUKEMIA IN CHRONIC PHASE - A COMPARISON OF TRANSPLANT VERSUS NO-TRANSPLANT IN A COHORT OF 258 PATIENTS 1ST SEEN IN ITALY BETWEEN 1984 AND 1986

Author

Tura, S, Fanin, R, Russo, D, Zuffa, F, Fiacchini, M, Baccarani, M, Testoni, N, Zamagni, D, Zaccaria, A, Damiani, D, Michieli, M, Alimena, G, Montefusco, E, Mandelli, F, Morra, E, Bernasconi, C, Guglielmi, P, Cacciola, E, Battista, R, Dini, E, Specchia, G, Liso, V, Majolino, I, Caronia, F, Leoni, P, Danieli, G, Nosari, A, Decataldo, F, Paolino, F, Resegotti, L, Comotti, B, Barbui, T, Scapoli, G, Castoldi, G, Prossomariti, L, Montuori, R, Riccardi, A, Ascari, E, Landolfi, R, Bizzi, B, Lombardo, M, Torlontano, G, Leoni, F, Ferrini, P, Sparaventi, G, Delfini, C, Papineschi, F, Spremolla, G, Broccia, G, Nardelli, S, Ciccone, F, Deriu, L, Miraglia, E, Debiase, R, Bodenizza, C, Carotenuto, M, Rotondo, S, Gentilini, I, Coser, P, Capucci, A, Izzi, T, Luciano, L, Rotoli, B, Iacopino, P, Nobile, F, Cantonetti, M, Papa, G, Pinotti, G, Sala, G, Foa, P, Maiolo, M, Avanzini, P, Gobbi, F, Dore, F, Pardini, S, Ambrosetti, A, Perona, G, Dini, D, Liberati, A, Martelli, M, Grignani, F, Montuoro, A, Delaurenzi, A, Gallo, E, Pileri, A, Gallamini, A, Buffa, F, Abbadessa, A, Bruzzese, L, Derosa, C, Cimino, R, Mangoni, L, Rizzoli, V, Pizzuti, M, Ricciuti, F, Galieni, P, Dispensa, E, Zagonel, V, Pinto, A, Musolino, C, Squadrito, G, Perricone, R, Cajozzo, A, Morandi, S, Bianchini, E, Miliani, A, Monaco, M, Difrancesco, A, Quaglino, D, Rosti, G, Marangolo, M, Pasini, F, Diperri, T, Aglietta, M, and Gavosto, F

Subjects
RISK, Settore MED/06 - Oncologia Medica, CHRONIC MYELOGENOUS LEUKEMIA, CHRONIC GRANULOCYTIC-LEUKEMIA, CHEMOTHERAPY, IRRADIATION, RELAPSE, Settore MED/15 - Malattie del Sangue
Published
1993

5. PROGNOSTIC FACTORS IN CHRONIC MYELOID-LEUKEMIA - RELATIONSHIP WITH INTERFERON AND BONE-MARROW TRANSPLANTATION

Author

Tura, S, Russo, D, Fanin, R, Zuffa, E, Patriarca, F, Fiacchini, M, Baccarani, M, Testoni, N, Zamagni, M, Zaccaria, A, Montefusco, E, Alimena, G, Meloni, G, Mandelli, F, Damiani, D, Michieli, M, Silvestri, F, Virgolini, L, Criscuolo, D, Fowst, C, Holdener, E, Specchia, G, Liso, V, Morra, E, Bernasconi, C, Demilio, A, Battista, R, Ditucci, A, Broccia, G, Majolino, I, Caronia, F, Luciano, L, Rotoli, B, Leoni, P, Bodenizza, C, Carotenuto, M, Rotondo, S, Nosari, A, Decataldo, F, Montuoro, A, Delaurenzi, A, Liberati, A, Tabilio, A, Martelli, M, Rambaldi, A, Barbui, T, Leoni, F, Ciolli, S, Ronca, F, Nobile, F, Paolino, F, Resegotti, L, Papineschi, F, Spremolla, G, Landolfi, R, Leone, G, Volpe, E, Mangoni, L, Rizzoli, V, Capucci, A, Izzi, T, Gentilini, I, Coser, P, Gallo, E, Pileri, A, Cantonetti, M, Papa, G, Dini, D, Diprisco, U, Morandi, S, Bianchini, E, Pinotti, G, Venco, A, Zagonel, V, Pinto, A, Capaldi, A, Giovannelli, E, Pizzuti, M, Ricciuti, F, Ambrosetti, A, Perona, G, Perricone, R, Cajozzo, A, Lombardo, M, Torlontano, G, Delfini, C, Lucarelli, G, Girino, M, and Ascari, E

Subjects
CHRONIC MYELOID LEUKEMIA, PROGNOSIS, INTERFERON Addresses, Settore MED/06 - Oncologia Medica, BONE MARROW TRANSPLANTATION, Settore MED/15 - Malattie del Sangue
Published
1993

6. KARYOTYPIC CONVERSION BY INTERFERON AS PREPARATIVE TREATMENT FOR AUTOLOGOUS BMT IN PH POSITIVE CML

Author

Gobbi, M, Tura, S, Russo, D, Zuffa, E, Patriarca, F, Fiacchini, M, Baccarani, M, Montefusco, E, Meloni, G, Mandelli, F, Zamagni, M, Testoni, N, Zaccaria, A, Fanin, R, Damiani, D, Michieli, M, Criscuolo, D, Fowst, C, Holdener, E, Specchia, G, Liso, V, Demilio, A, Battista, R, Ditucci, A, Broccia, G, Bodenizza, C, Carotenuto, M, Rotondo, G, Ambrosetti, A, Perona, G, Majolino, I, Caronia, F, Luciano, L, Rotoli, B, Morra, E, Bernasconi, C, Rambaldi, A, Barbui, T, Ronco, F, Nobile, F, Leoni, P, Nosari, A, Decataldo, F, Montuoro, A, Delaurenzi, A, Camillo, S, Gentilini, I, Coser, P, Dini, D, Diprisco, U, Papineschi, F, Spremolla, G, Liberati, A, Grignani, G, Tabilio, A, Martelli, M, Pardini, S, Longinotti, M, Mangoni, L, Rizzoli, V, Galieni, P, Dispensa, E, Abbadessa, A, Bruzzese, L, Leoni, F, Ciolli, S, Cantonetti, M, Papa, G, Landolfi, R, Leone, G, Gallo, E, Pileri, A, Zagonel, V, Pinto, A, Volpe, E, Difrancesco, A, Quaglino, D, Avanzini, P, Gobbi, F, Paolino, F, Resegotti, L, Saglio, G, Camaschella, C, Mazza, U, Pinotti, G, Venco, G, Capucci, A, Izzi, T, Morandi, S, Bianchini, E, Scapoli, G, Monaco, M, Pizzuti, M, Ricciuti, F, Capaldi, A, and Giovannelli, E

Subjects
INTERFERON, AUTOLOGOUS BMT, Settore MED/06 - Oncologia Medica, KARYOTYPIC CONVERSION, Settore MED/15 - Malattie del Sangue, PH+CML
Published
1993

7. TREATMENT OF PH-POSITIVE CHRONIC MYELOID-LEUKEMIA WITH ALPHA-INTERFERON (ROFERON-A) - THE ITALIAN COOPERATIVE STUDY-GROUP EXPERIENCE

Author

Tura, S, Russo, D, Zuffa, E, Fanin, R, Patriarca, F, Fiacchini, M, Baccarani, M, Testoni, N, Zamagni, M, Zaccaria, A, Montefusco, E, Alimena, G, Meloni, G, Mandelli, F, Damiani, D, Michieli, M, Criscuolo, D, Fowst, C, Holdener, E, Specchia, G, Liso, V, Morra, E, Bernasconi, C, Demilio, A, Battista, R, Ditucci, A, Broccia, G, Maiolino, I, Caronia, F, Luciano, L, Rotoli, B, Leoni, P, Danieli, G, Bodenizza, C, Carotenuto, M, Rotondo, S, Nosari, A, Decataldo, F, Montuoro, A, Delaurenzi, A, Camillo, S, Liberati, A, Grignani, F, Tabilio, A, Rambaldi, A, Barbui, T, Leoni, F, Ciolli, S, Ronca, F, Nobile, F, Paolino, F, Resegotti, L, Papineschi, F, Spremolla, G, Landolfi, R, Leone, G, Volpe, E, Mangoni, L, Rizzoli, V, Capucci, A, Izzi, T, Scapoli, G, Castoldi, G, Gentilini, I, Coser, P, Gallo, E, Pileri, A, Cantonetti, M, Papa, G, Dini, D, Diprisco, U, Morandi, S, Bianchini, E, Pinotti, G, Venco, A, Zagonel, V, Pinto, A, Capaldi, A, Giovannelli, E, Pizzuti, M, Ricciuti, F, Ambrosetti, A, Perona, G, Perricone, R, Cajozzo, A, Lombardo, M, Torlontano, G, Delfini, C, Lucarelli, G, Girino, M, Ascari, E, Risso, M, Damasio, E, Martino, S, Pardini, S, Longinotti, M, Miraglia, E, Debiase, R, Nardelli, S, Ciccone, F, Galieni, P, Dispensa, E, Abbadessa, A, Bruzzese, L, Prossomariti, L, Cimino, R, Derosa, C, Gabbas, A, Francesco, S, Gallamini, A, Difrancesco, A, Quaglino, D, Musolino, C, Squadrito, G, Avanzini, P, Gobbi, F, Nuova, A, Emilia, R, Saglio, G, Aglietta, M, Camaschella, C, Mazza, M, Guglielmo, P, Cacciola, E, and Monaco, M

Subjects
CHRONIC MYELOID LEUKEMIA, PHILADELPHIA CHROMOSOME, INTERFERON AUTOLOGOUS BONE MARROW TRANSPLANT, Settore MED/06 - Oncologia Medica, Settore MED/15 - Malattie del Sangue
Published
1993

8. CONFIRMATION AND IMPROVEMENT OF SOKAL PROGNOSTIC CLASSIFICATION OF PH+ CHRONIC MYELOID-LEUKEMIA - THE VALUE OF EARLY EVALUATION OF THE COURSE OF THE DISEASE

Author

Tura, S, Russo, D, Zuffa, E, Fiacchini, M, Baccarani, M, Testoni, N, Zamagni, D, Zaccaria, A, Fanin, R, Damiani, D, Michieli, M, Alimena, G, Montefusco, E, Mandelli, F, Morra, E, Bernasconi, C, Guglielmi, P, Cacciola, E, Battista, R, Dini, E, Specchia, G, Liso, V, Majolino, I, Caronia, F, Leoni, P, Danieli, G, Nosari, A, Decataldo, F, Paolino, F, Resegotti, L, Comotti, B, Barbui, T, Scapoli, G, Castoldi, G, Prossomariti, L, Montuori, R, Riccardi, A, Ascari, E, Landolfi, R, Bizzi, B, Lombardo, M, Torlontano, G, Leoni, F, Ferrini, P, Sparaventi, G, Lucarelli, G, Papineschi, F, Spremolla, G, Broccia, G, Nardelli, S, Ciccone, F, Deriu, L, Miraglia, E, Debiase, R, Bodenizza, C, Carotenuto, M, Rotondo, S, Gentilini, I, Coser, P, Capucci, A, Izzi, T, Luciano, L, Rotoli, B, Iacopino, P, Nobile, F, Cantonetti, M, Papa, G, Pinotti, G, Sala, G, Foa, P, Maiolo, M, Avanzini, P, Gobbi, F, Dore, F, Longinotti, M, Ambrosetti, A, Perona, G, Dini, D, Diprisco, U, Liberati, A, Martelli, M, Grignani, F, Montuoro, A, Delaurenzi, A, Gallo, E, Pileri, A, Gallamini, A, Buffa, F, Abbadessa, A, Bruzzese, L, Derosa, C, Cimino, R, Mangoni, L, Rizzoli, V, Pizzuti, M, Ricciuti, F, Galieni, P, Dispensa, E, Zagonel, V, Pinto, A, Musolino, C, Squadrito, G, Perricone, R, Cajozzo, A, Morandi, S, Bianchini, E, Miliani, A, Monaco, M, Difrancesco, A, Quaglino, D, Rosti, G, Marangolo, M, Pasini, F, Diperri, T, Aglietta, M, and Gavosto, F

Subjects
MARROW TRANSPLANTATION, CHRONIC MYELOCYTIC-LEUKEMIA, Settore MED/06 - Oncologia Medica, CHRONIC MYELOGENOUS LEUKEMIA, DURATION, SURVIVAL, CHRONIC PHASE, CHRONIC GRANULOCYTIC-LEUKEMIA, MULTIVARIATE-ANALYSIS, BCR BREAKPOINT, DIAGNOSIS, Settore MED/15 - Malattie del Sangue
Published
1991

9. Allogeneic bone marrow transplantation versus autologous stem cell transplantation in multiple myeloma: A retrospective case-matched study from the European group for blood and marrow transplantation

Author

UCL - Cliniques universitaires Saint-Luc, UCL - MD/MINT - Département de médecine interne, Bjorkstrand, B., Ferrant, Augustin, Ljungman, P., Svensson, H, Hermans, J., Alegre, A., Apperley, JF., Blade, J., Carlson, K., Cavo, M., Goldstone, AH., Delaurenzi, A., Majolino, I, Marcus, R, Prentice, HG., Remes, K., Samson, D., Sureda, A., Verdonck, LF., Volin, L, Gahrton, G., UCL - Cliniques universitaires Saint-Luc, UCL - MD/MINT - Département de médecine interne, Bjorkstrand, B., Ferrant, Augustin, Ljungman, P., Svensson, H, Hermans, J., Alegre, A., Apperley, JF., Blade, J., Carlson, K., Cavo, M., Goldstone, AH., Delaurenzi, A., Majolino, I, Marcus, R, Prentice, HG., Remes, K., Samson, D., Sureda, A., Verdonck, LF., Volin, L, and Gahrton, G.

Abstract

A retrospective case-matched analysis was performed comparing 189 myeloma patients treated with allogeneic bone marrow transplantation (allo-BMT) with an equal number of patients who received autologous stem cell transplantation (ASCT). Matching was performed with respect to gender and number of treatment lines before transplantation. The groups were comparable with the exception of median age (43 years for allo-BMT v 49 years for ASCT, P = .0001) and median posttransplant follow-up (46 months for allo-BMT v 30 months for ASCT, P = .0003). The overall survival was significantly better for ASCT than for allo-BMT, with a median survival of 34 months and 18 months, respectively (P = .001). However, this survival advantage was only observed in men, but not in women. The statistically significant survival advantage for ASCT was seen in most subgroups, ie, chemotherapy-responsive patients, patients who had received two or more treatment lines before transplantation, patients in partial remission, patients with an IgG-subtype, patients older than 46 years of age, patients with stage II disease, and patients with a low or high serum-beta-2-microglobulin at diagnosis. The main reason for the poorer survival in allo-BMT patients was higher transplant-related mortality (41% v 13% for ASCT, P = .0001), which was not compensated for by a lower rate of relapse and progression. However, in patients alive at 1 year posttransplant, there was a trend for better long-term survival (P = .09) and significantly better progression-free survival (P = .02) for allo-BMT as compared with ASCT. We conclude that the median survival is superior for ASCT. However, allo-BMT has a lower relapse rate, which results in a similar long-term outcome for both approaches, but a longer follow-up is needed to assess the final outcome. (C) 1996 by The American Society of Hematology.

Published
1996

10. Autologous Stem-cell Transplantation in Multiple-myeloma - Results of the European Group for Bone-marrow Transplantation

Author

UCL - Cliniques universitaires Saint-Luc, UCL - MD/MINT - Département de médecine interne, Bjorkstrand, B., Ferrant, Augustin, Ljungman, P., Bird, JM., Samson, D., Brandt, L., Alegre, A., Auzanneau, G., Blade, J., Brunet, S., Carlson, K., Cavo, M., Gravett, P., Delaurenzi, A., Prentice, HG., Proctor, S., Remes, K., Troussard, X., Verdonck, LF., Williams, C., Gahrton, G., UCL - Cliniques universitaires Saint-Luc, UCL - MD/MINT - Département de médecine interne, Bjorkstrand, B., Ferrant, Augustin, Ljungman, P., Bird, JM., Samson, D., Brandt, L., Alegre, A., Auzanneau, G., Blade, J., Brunet, S., Carlson, K., Cavo, M., Gravett, P., Delaurenzi, A., Prentice, HG., Proctor, S., Remes, K., Troussard, X., Verdonck, LF., Williams, C., and Gahrton, G.

Abstract

Autologous hematopoietic stem cell transplantation was used for treatment of 384 patients with multiple myeloma in 37 centers during the years 1986-1991. An analysis of prognostic factors was performed in 207 of these patients. One hundred forty one were males and 66 females, and median age was 49 years (range, 24-68). Actuarial survival at 78 months is 45%. Factors associated with a good prognosis were: response on chemotherapy immediately pretransplant, administration of only one treatment regimen, a low serum-beta(2)-Microglobulin value at diagnosis and the use of a conditioning regimen including melphalan. In a multivariate analysis, response status pretransplant, age <45 years, melphalan conditioning and non-TBI conditioning were independently predictive for longer survival, while transplantation after only one line of primary treatment and isotype other than light-chain were of borderline significance. Posttransplant alpha-interferon treatment was associated with improved survival in responsive patients. Eighteen patients treated in one center (Huddinge) passed a double autograft program, and 14 are in continuous complete remission ([CR]; n = 10) or good partial remission (n = 4) at a median time of 17 months after the first transplant (range, 2-38). In five CR patients, polymerase chain reaction (PCR)analysis of the clone-specific immunoglobulin-rearrangement was performed, and four are PCR-negative up to 33+ months after the first transplantation. We conclude that autografting in myeloma is most effective when applied early in the course of disease in younger, chemotherapy-responsive patients. Alpha-interferon maintenance treatment seems to be beneficial with respect to improved survival. Repeated cycles of high-dose chemo-radiotherapy with autologous stem cell rescue can induce a very high response rate, where the absence of minimal residual disease in CR patients has been demonstrated by the highly sensitive PCR-technique.

Published
1995

15. Therapy of acute myeloid leukemia (AML) in elderly patients: preliminary results of a GIMEMA study group trial

Author

Petti, M.C., Resegotti, L., Spiriti, M.A. Aloe, Carotenuto, M., Biase, R. de, DeLaurenzi, A., Fioritoni, G., Leoni, P., Nobile, F., Papa, G., Ferrini, P.L. Rossi, Spadea, A., Amadori, S., and Mandelli, F.

Subjects
Acute leukemia, Promyelocytic -- Drug therapy, Cytarabine -- Health aspects, Mitoxantrone hydrochloride -- Health aspects, Aged -- Diseases, Health, Science and technology
Abstract

AUTHORS: M.C. Petti, L. Resegotti, M.A. Aloe Spiriti, M. Carotenuto, R. de Biase, A. DeLaurenzi, G. Fioritoni, P. Leoni, F. Nobile, G. Papa, P.L. Rossi Ferrini, A. Spadea, S. Amadori [...]

Published
1991

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