Complete response in myeloma extends survival without, but not with history of prior monoclonal gammopathy of undetermined significance or smouldering disease
Open Access
- 8 December 2006
- journal article
- research article
- Published by Wiley in British Journal of Haematology
- Vol. 136 (3), 393-399
- https://doi.org/10.1111/j.1365-2141.2006.06441.x
Abstract
Complete response (CR) is still considered an important surrogate marker for outcome in multiple myeloma (MM). Long‐term survival after transplantation, however, has been observed in a substantial proportion of patients who never achieved CR. The tandem transplant trial, Total Therapy 2, enrolled 668 patients, who were randomised up‐front to thalidomide (THAL) or no THAL; 56 patients were identified as having had, for at least 6 months prior to initiation of therapy, monoclonal gammopathy of undetermined significance (MGUS, n = 21), smouldering MM (SMM, n = 22) or solitary plasmacytoma of bone (SPC, n = 13). The clinical characteristics and outcomes of patients with such ‘evolved’ MM (E‐MM) and of those with ‘unknown’ prior history (U‐MM) were compared. Fewer patients with MGUS/SMM‐E‐MM had anaemia or renal failure; CR was lower (22% vs. 48%) but 4‐year estimates of event‐free survival (54% vs. 56% with U‐MM) and overall survival (65% vs. 70% with U‐MM) were similar to those with SPC‐E‐MM or U‐MM. In the latter group, achieving CR was associated with prolonged survival. In comparison with U‐MM, E‐MM evolved from MGUS/SMM was associated with lower CR rate without adversely affecting survival. In contrast, CR was an independent favourable feature for survival in U‐MM.This publication has 31 references indexed in Scilit:
- The molecular classification of multiple myelomaBlood, 2006
- Combination therapy with lenalidomide plus dexamethasone (Rev/Dex) for newly diagnosed myelomaBlood, 2005
- Phase 1 trial of the proteasome inhibitor bortezomib and pegylated liposomal doxorubicin in patients with advanced hematologic malignanciesBlood, 2005
- Magnitude of Response With Myeloma Frontline Therapy Does Not Predict Outcome: Importance of Time to Progression in Southwest Oncology Group Chemotherapy TrialsJournal of Clinical Oncology, 2004
- Single versus Double Autologous Stem-Cell Transplantation for Multiple MyelomaThe New England Journal of Medicine, 2003
- Immunomodulatory drug CC-5013 overcomes drug resistance and is well tolerated in patients with relapsed multiple myelomaBlood, 2002
- A Long-Term Study of Prognosis in Monoclonal Gammopathy of Undetermined SignificanceThe New England Journal of Medicine, 2002
- CRITERIA FOR EVALUATING DISEASE RESPONSE AND PROGRESSION IN PATIENTS WITH MULTIPLE MYELOMA TREATED BY HIGH‐DOSE THERAPY AND HAEMOPOIETIC STEM CELL TRANSPLANTATIONBritish Journal of Haematology, 1998
- Multiple MyelomaThe New England Journal of Medicine, 1997
- Nonparametric Estimation from Incomplete ObservationsJournal of the American Statistical Association, 1958