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Clinical features and survival of 338 multiple myeloma patients treated with hematopoietic stem cell transplantation or conventional chemotherapy
Author(s) -
Pérez Raúl,
Durán Mª Sol,
Mayans Jose,
Soler Alfons,
Castillo Inmaculada,
Jurado Manuel,
Ribas Paz,
Menchaca Echevarria Mª Carmen,
Hernandez Miguel T.,
Lopez GarciaCarreño Mª Dolores,
Echeveste Gutierrez Asunción,
Bailen Garcia Alicia,
Lopez Silvia,
Baquero Jose,
Ramirez Gemma
Publication year - 2016
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.12611
Subject(s) - medicine , multiple myeloma , hematopoietic stem cell transplantation , chemotherapy , transplantation , adverse effect , gastroenterology , retrospective cohort study , autologous stem cell transplantation , anemia , surgery , oncology
Therapeutic approaches against multiple myeloma ( MM ) have largely changed during the past decade. Hematopoietic stem cell transplantation ( HSCT ) and licensing of immunomodulators and proteasome inhibitors have resulted in better response and increased overall survival rates compared to previous conventional therapies. To assess the impact that these new strategies have had on outcome of patients with symptomatic MM in S pain, we conducted an epidemiological retrospective analysis of 338 newly diagnosed patients with stage II ‐ III MM who started first‐line treatment over a 2‐yr period (2003–2005) by collecting data from their medical records. Most patients had been diagnosed with secretory MM (94.4%), 41.7% stage II and 58.3% stage III . The presence of bone lesions (72.2%), as well as anemia (79.8%) and elevated beta2‐microglobulin levels (62.3%), was a common finding; in contrast, hypercalcemia and elevated serum creatinine were less frequent (25% each). First‐line treatment had consisted of either conventional chemotherapy (62%) or induction treatment plus autologous HSCT (38%), as per standard clinical practice. HSCT not only resulted in greater objective response rates (93% vs. 50%), but also contributed to a significant increase in 3‐yr survival (85% vs. 49.7%; 95% CI , range 77–91 vs. 41–58; P < 0.001). Overall, 55% of patients presented treatment‐related adverse events, mainly hematological. Toxicity rates were higher among patients treated with alkylating‐based regimens and in those undergoing transplantation. In conclusion, data analysis shows an adequate balance between increased response rates and safety that supports the use of up‐front high‐dose HSCT therapy in younger patients. Most importantly, this study provides further confirmation that the introduction of HSCT has significantly prolonged survival of patients with MM .