Total therapy-based treatment for multiple myeloma—a single center experience

Incorporation of novel biological agents has become the cornerstone of treatment in multiple myeloma. For the last 4 years we have adopted the more intensified approach, previously published as total therapy 3 by the Arkansas group and used it with local modifications. This study aims to evaluate th...

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Bibliographic Details
Published in:Annals of hematology 2010, Vol.89 (1), p.53-59
Main Authors: Magen-Nativ, Hila, Ram, Ron, Yeshurun, Moshe, Gafter-Gvili, Anat, Raanani, Pia, Shpilberg, Ofer
Format: Article
Language:English
Subjects:
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Cisplatin - therapeutic use
Combined Modality Therapy - methods
Cyclophosphamide - therapeutic use
Dexamethasone - therapeutic use
Doxorubicin - therapeutic use
Etoposide - therapeutic use
Female
Hematology
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Multiple Myeloma - mortality
Multiple Myeloma - therapy
Oncology
Original Article
Retrospective Studies
Stem Cell Transplantation - mortality
Survival Rate - trends
Thalidomide - therapeutic use
Transplantation, Autologous
Treatment Outcome
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Summary:Incorporation of novel biological agents has become the cornerstone of treatment in multiple myeloma. For the last 4 years we have adopted the more intensified approach, previously published as total therapy 3 by the Arkansas group and used it with local modifications. This study aims to evaluate the efficacy and safety of the Arkansas protocol-based treatment outside clinical trial in a tertiary medical center in Israel. We retrospectively analyzed 23 patients. Seventy-three percent of the patients achieved very good partial remission (VGPR) before autologous stem cell transplantation (ASCT). Eighty-six percent of the patients achieved at least VGPR after tandem ASCT. Two-year overall survival was estimated as 70%. Four patients died during treatment, one as a result of disease progression. We conclude that this protocol is effective and rather safe. Further clinical trials should assess which subgroups of patients would benefit most from this approach.
ISSN:0939-5555
1432-0584
DOI:10.1007/s00277-009-0767-x