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

• 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
• ISSN: 0939-5555; 1432-0584
• DOI: 10.1007/s00277-009-0767-x

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.