Article: A staged approach with vincristine, adriamycin and dexamethasone followed by bortezomib, thalidomide and dexamethasone before autologous hematopoietic stem cell transplantation in the treatment of newly diagnosed multiple myeloma
| Title | A staged approach with vincristine, adriamycin and dexamethasone followed by bortezomib, thalidomide and dexamethasone before autologous hematopoietic stem cell transplantation in the treatment of newly diagnosed multiple myeloma | ||||
|---|---|---|---|---|---|
| Authors | Chim, CS1 Lie, AKW1 Chan, EYT1 Leung, YY1 Cheung, SCW1 Chan, SYT1 Liang, R1 Kwong, YL1 | ||||
| Issue Date | 2010 | ||||
| Publisher | Springer Verlag. The Journal's web site is located at http://link.springer.de/link/service/journals/00277/index.htm | ||||
| Citation | Annals of Hematology, 2010, v. 89 n. 10, p. 1019-1027 [How to Cite?] DOI: http://dx.doi.org/10.1007/s00277-010-0959-4 | ||||
| Abstract | Bortezomib-based regimens have significant activities in multiple myeloma (MM). In this study, we tested the efficacy of a total therapy with a staged approach where newly diagnosed MM patients received vincristine/adriamycin/dexamethsone (VAD). VAD-sensitive patients (> or =75% paraprotein reduction) received autologous hematopoietic stem cell transplantation (auto-HSCT), whereas less VAD-sensitive patients (<75% paraprotein reduction) received bortezomib/thalidomide/dexamethasone (VTD) for further cytoreduction prior to auto-HSCT. On an intention-to-treat analysis, a progressive increase of complete remission (CR) rates was observed, with cumulative CR rates of 48% after HSCT. Seven patients progressed leading to three fatalities, of which two had central nervous system disease. The 3-year overall survival and event-free survival were 75.1% and 48.3%, respectively. Six patients developed oligoclonal reconstitution with new paraproteins. In the absence of anticoagulant prophylaxis, no patients developed deep vein thrombosis. The staged application of VAD+/-VTD/auto-HSCT resulted in an appreciable response rate and promising survivals. Our approach reduced the use of bortezomib without compromising the ultimate CR rate and is of financial significance for less affluent communities. | ||||
| ISSN | 0939-5555 2011 Impact Factor: 2.615 2011 SCImago Journal Rankings: 0.306 | ||||
| DOI | http://dx.doi.org/10.1007/s00277-010-0959-4 | ||||
| ISI Accession Number ID | WOS:000281161400010
Funding Information: We thank Drs Joyce Chan, Bonnie Khoo, Herman Liu, Thomas Lau from Pamela Youde Nethersole East Hospital; Drs Dominic Yeung, M.F. Law, Candia Chan and L.G. Wong from Tuen Mun Hospital; Drs K.K. Lee, Joycelyn Sim, Vivien Mak and Sandy Ho from Princess Margaret Hospital, for their patient referral and management. We also thank Mr Edwin Leong for funding support of bortezomib. | ||||
| PubMed Central ID | PMC2924968 |
| dc.contributor.author | Chim, CS | ||||
|---|---|---|---|---|---|
| dc.contributor.author | Lie, AKW | ||||
| dc.contributor.author | Chan, EYT | ||||
| dc.contributor.author | Leung, YY | ||||
| dc.contributor.author | Cheung, SCW | ||||
| dc.contributor.author | Chan, SYT | ||||
| dc.contributor.author | Liang, R | ||||
| dc.contributor.author | Kwong, YL | ||||
| dc.date.accessioned | 2010-10-19T04:34:10Z | ||||
| dc.date.available | 2010-10-19T04:34:10Z | ||||
| dc.date.issued | 2010 | ||||
| dc.description.abstract | Bortezomib-based regimens have significant activities in multiple myeloma (MM). In this study, we tested the efficacy of a total therapy with a staged approach where newly diagnosed MM patients received vincristine/adriamycin/dexamethsone (VAD). VAD-sensitive patients (> or =75% paraprotein reduction) received autologous hematopoietic stem cell transplantation (auto-HSCT), whereas less VAD-sensitive patients (<75% paraprotein reduction) received bortezomib/thalidomide/dexamethasone (VTD) for further cytoreduction prior to auto-HSCT. On an intention-to-treat analysis, a progressive increase of complete remission (CR) rates was observed, with cumulative CR rates of 48% after HSCT. Seven patients progressed leading to three fatalities, of which two had central nervous system disease. The 3-year overall survival and event-free survival were 75.1% and 48.3%, respectively. Six patients developed oligoclonal reconstitution with new paraproteins. In the absence of anticoagulant prophylaxis, no patients developed deep vein thrombosis. The staged application of VAD+/-VTD/auto-HSCT resulted in an appreciable response rate and promising survivals. Our approach reduced the use of bortezomib without compromising the ultimate CR rate and is of financial significance for less affluent communities. | ||||
| dc.description.nature | published_or_final_version | ||||
| dc.description.other | Springer Open Choice, 01 Dec 2010 | ||||
| dc.identifier.citation | Annals of Hematology, 2010, v. 89 n. 10, p. 1019-1027 [How to Cite?] DOI: http://dx.doi.org/10.1007/s00277-010-0959-4 | ||||
| dc.identifier.citeulike | 7151235 | ||||
| dc.identifier.doi | http://dx.doi.org/10.1007/s00277-010-0959-4 | ||||
| dc.identifier.eissn | 1432-0584 | ||||
| dc.identifier.epage | 1027 | ||||
| dc.identifier.hkuros | 172201 | ||||
| dc.identifier.isi | WOS:000281161400010
Funding Information: We thank Drs Joyce Chan, Bonnie Khoo, Herman Liu, Thomas Lau from Pamela Youde Nethersole East Hospital; Drs Dominic Yeung, M.F. Law, Candia Chan and L.G. Wong from Tuen Mun Hospital; Drs K.K. Lee, Joycelyn Sim, Vivien Mak and Sandy Ho from Princess Margaret Hospital, for their patient referral and management. We also thank Mr Edwin Leong for funding support of bortezomib. | ||||
| dc.identifier.issn | 0939-5555 2011 Impact Factor: 2.615 2011 SCImago Journal Rankings: 0.306 | ||||
| dc.identifier.issue | 10 | ||||
| dc.identifier.pmcid | PMC2924968 | ||||
| dc.identifier.pmid | 20428873 | ||||
| dc.identifier.scopus | eid_2-s2.0-77956707989 | ||||
| dc.identifier.spage | 1019 | ||||
| dc.identifier.uri | http://hdl.handle.net/10722/124026 | ||||
| dc.identifier.volume | 89 | ||||
| dc.language | eng | ||||
| dc.publisher | Springer Verlag. The Journal's web site is located at http://link.springer.de/link/service/journals/00277/index.htm | ||||
| dc.publisher.place | Germany | ||||
| dc.relation.ispartof | Annals of Hematology | ||||
| dc.rights | Creative Commons: Attribution 3.0 Hong Kong License | ||||
| dc.subject.mesh | Antineoplastic Agents - therapeutic use | ||||
| dc.subject.mesh | Antineoplastic Combined Chemotherapy Protocols - therapeutic use | ||||
| dc.subject.mesh | Boronic Acids - therapeutic use | ||||
| dc.subject.mesh | Hematopoietic Stem Cell Transplantation | ||||
| dc.subject.mesh | Multiple Myeloma - diagnosis - pathology - physiopathology - therapy | ||||
| dc.title | A staged approach with vincristine, adriamycin and dexamethasone followed by bortezomib, thalidomide and dexamethasone before autologous hematopoietic stem cell transplantation in the treatment of newly diagnosed multiple myeloma | ||||
| dc.type | Article |
Author Affiliations
- The University of Hong Kong