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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
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TitleA 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
 
AuthorsChim, CS1
Lie, AKW1
Chan, EYT1
Leung, YY1
Cheung, SCW1
Chan, SYT1
Liang, R1
Kwong, YL1
 
Issue Date2010
 
PublisherSpringer Verlag. The Journal's web site is located at http://link.springer.de/link/service/journals/00277/index.htm
 
CitationAnnals of Hematology, 2010, v. 89 n. 10, p. 1019-1027 [How to Cite?]
DOI: http://dx.doi.org/10.1007/s00277-010-0959-4
 
AbstractBortezomib-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.
 
ISSN0939-5555
2013 Impact Factor: 2.396
 
DOIhttp://dx.doi.org/10.1007/s00277-010-0959-4
 
PubMed Central IDPMC2924968
 
ISI Accession Number IDWOS:000281161400010
Funding AgencyGrant Number
bortezomib
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 FieldValue
dc.contributor.authorChim, CS
 
dc.contributor.authorLie, AKW
 
dc.contributor.authorChan, EYT
 
dc.contributor.authorLeung, YY
 
dc.contributor.authorCheung, SCW
 
dc.contributor.authorChan, SYT
 
dc.contributor.authorLiang, R
 
dc.contributor.authorKwong, YL
 
dc.date.accessioned2010-10-19T04:34:10Z
 
dc.date.available2010-10-19T04:34:10Z
 
dc.date.issued2010
 
dc.description.abstractBortezomib-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.naturepublished_or_final_version
 
dc.description.otherSpringer Open Choice, 01 Dec 2010
 
dc.identifier.citationAnnals 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.citeulike7151235
 
dc.identifier.doihttp://dx.doi.org/10.1007/s00277-010-0959-4
 
dc.identifier.eissn1432-0584
 
dc.identifier.epage1027
 
dc.identifier.hkuros172201
 
dc.identifier.isiWOS:000281161400010
Funding AgencyGrant Number
bortezomib
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.issn0939-5555
2013 Impact Factor: 2.396
 
dc.identifier.issue10
 
dc.identifier.pmcidPMC2924968
 
dc.identifier.pmid20428873
 
dc.identifier.scopuseid_2-s2.0-77956707989
 
dc.identifier.spage1019
 
dc.identifier.urihttp://hdl.handle.net/10722/124026
 
dc.identifier.volume89
 
dc.languageeng
 
dc.publisherSpringer Verlag. The Journal's web site is located at http://link.springer.de/link/service/journals/00277/index.htm
 
dc.publisher.placeGermany
 
dc.relation.ispartofAnnals of Hematology
 
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License
 
dc.subject.meshAntineoplastic Agents - therapeutic use
 
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols - therapeutic use
 
dc.subject.meshBoronic Acids - therapeutic use
 
dc.subject.meshHematopoietic Stem Cell Transplantation
 
dc.subject.meshMultiple Myeloma - diagnosis - pathology - physiopathology - therapy
 
dc.titleA 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.typeArticle
 
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<contributor.author>Cheung, SCW</contributor.author>
<contributor.author>Chan, SYT</contributor.author>
<contributor.author>Liang, R</contributor.author>
<contributor.author>Kwong, YL</contributor.author>
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Author Affiliations
  1. The University of Hong Kong