Intensive therapy for multiple myeloma in patients younger than 60 years. Long-term results focusing on the effect of the degree of response on survival and relapse pattern after transplantation

Stig Lenhoff; Martin Hjorth; Ingemar Turesson; Jan Westin; Peter Gimsing; Finn Wislöff; Lucia Ahlberg; Kristina Carlson; Ilse Christiansen; Inger Marie Dahl; Karin Forsberg; Lorentz Brinch; Jens Hammerström; Hans E Johnsen; Lene Meldgaard Knudsen; Olle Linder; Ulf-Henrik Mellqvist; Ingerid Nesthus; Johan Lanng Nielsen; Nordic Myeloma Study Group

Intensive therapy for multiple myeloma in patients younger than 60 years. Long-term results focusing on the effect of the degree of response on survival and relapse pattern after transplantation

Stig Lenhoff, Martin Hjorth, Ingemar Turesson, Jan Westin, Peter Gimsing, Finn Wislöff, Lucia Ahlberg, Kristina Carlson, Ilse Christiansen, Inger Marie Dahl, Karin Forsberg, Lorentz Brinch, Jens Hammerström, Hans E Johnsen, Lene Meldgaard Knudsen, Olle Linder, Ulf-Henrik Mellqvist, Ingerid Nesthus, Johan Lanng Nielsen, Nordic Myeloma Study Group

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

62 Citationer (Scopus)

Abstract

BACKGROUND AND OBJECTIVES: From 1994 to 1997 we conducted a population-based, prospective study on intensive therapy in newly diagnosed symptomatic myeloma patients younger than 60 years, comparing their survival to that of a conventionally treated historic population. Long-term results are presented, including the impact of the degree of response on survival and relapse pattern after transplantation.

DESIGN AND METHODS: The prospective population was formed of 397 patients and the historic population of 313 patients. Both populations were calculated to comprise more than 75% of the expected number of new cases.

RESULTS: After a median follow-up of 7 years survival was longer in the prospective population than in the historic one (median 60 versus 39 months; p=0.0002). When comparing only patients eligible for intensive therapy the median survival was 63 versus 44 months (p<0.0001). Attaining a complete response was associated with prolonged event-free survival but not overall survival. The pattern of relapse after transplantation was heterogeneous but could be divided into four major groups; insidious, classical, plasmacytoma form and transformed disease. The median survival after relapse was 29 months. The relapse pattern and time to relapse predicted outcome. Patients relapsing with an insidious or classical form of disease with skeletal events only, or after a long lasting first response were likely to respond well to conventional salvage therapy. In contrast, relapse with multiple symptoms, transformed disease or a short duration of first response implied bad prognosis.

INTERPRETATION AND CONCLUSIONS: The relapse pattern after autologous transplantation is heterogeneous and response to salvage therapy is variable. The degree of response and event-free survival after transplantation are not reliable surrogate markers for survival.

Originalsprog	Engelsk
Tidsskrift	Haematologica
Vol/bind	91
Udgave nummer	9
Sider (fra-til)	1228-33
Antal sider	6
ISSN	0390-6078
Status	Udgivet - sep. 2006
Udgivet eksternt	Ja

AUB Link

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Citationsformater

Lenhoff, S., Hjorth, M., Turesson, I., Westin, J., Gimsing, P., Wislöff, F., Ahlberg, L., Carlson, K., Christiansen, I., Dahl, I. M., Forsberg, K., Brinch, L., Hammerström, J., Johnsen, H. E., Knudsen, L. M., Linder, O., Mellqvist, U-H., Nesthus, I., Nielsen, J. L., & Nordic Myeloma Study Group (2006). Intensive therapy for multiple myeloma in patients younger than 60 years. Long-term results focusing on the effect of the degree of response on survival and relapse pattern after transplantation. Haematologica, 91(9), 1228-33.

@article{59a0f2eb5e084525940ffe3e96dead48,

title = "Intensive therapy for multiple myeloma in patients younger than 60 years. Long-term results focusing on the effect of the degree of response on survival and relapse pattern after transplantation",

abstract = "BACKGROUND AND OBJECTIVES: From 1994 to 1997 we conducted a population-based, prospective study on intensive therapy in newly diagnosed symptomatic myeloma patients younger than 60 years, comparing their survival to that of a conventionally treated historic population. Long-term results are presented, including the impact of the degree of response on survival and relapse pattern after transplantation.DESIGN AND METHODS: The prospective population was formed of 397 patients and the historic population of 313 patients. Both populations were calculated to comprise more than 75% of the expected number of new cases.RESULTS: After a median follow-up of 7 years survival was longer in the prospective population than in the historic one (median 60 versus 39 months; p=0.0002). When comparing only patients eligible for intensive therapy the median survival was 63 versus 44 months (p<0.0001). Attaining a complete response was associated with prolonged event-free survival but not overall survival. The pattern of relapse after transplantation was heterogeneous but could be divided into four major groups; insidious, classical, plasmacytoma form and transformed disease. The median survival after relapse was 29 months. The relapse pattern and time to relapse predicted outcome. Patients relapsing with an insidious or classical form of disease with skeletal events only, or after a long lasting first response were likely to respond well to conventional salvage therapy. In contrast, relapse with multiple symptoms, transformed disease or a short duration of first response implied bad prognosis.INTERPRETATION AND CONCLUSIONS: The relapse pattern after autologous transplantation is heterogeneous and response to salvage therapy is variable. The degree of response and event-free survival after transplantation are not reliable surrogate markers for survival.",

keywords = "Adult, Female, Hematopoietic Stem Cell Transplantation, Humans, Male, Middle Aged, Multiple Myeloma, Salvage Therapy, Survival Rate, Transplantation, Autologous, Treatment Outcome",

author = "Stig Lenhoff and Martin Hjorth and Ingemar Turesson and Jan Westin and Peter Gimsing and Finn Wisl{\"o}ff and Lucia Ahlberg and Kristina Carlson and Ilse Christiansen and Dahl, {Inger Marie} and Karin Forsberg and Lorentz Brinch and Jens Hammerstr{\"o}m and Johnsen, {Hans E} and Knudsen, {Lene Meldgaard} and Olle Linder and Ulf-Henrik Mellqvist and Ingerid Nesthus and Nielsen, {Johan Lanng} and {Nordic Myeloma Study Group}",

year = "2006",

month = sep,

language = "English",

volume = "91",

pages = "1228--33",

journal = "Haematologica",

issn = "0390-6078",

publisher = "Ferrata Storti Foundation",

number = "9",

}

Lenhoff, S, Hjorth, M, Turesson, I, Westin, J, Gimsing, P, Wislöff, F, Ahlberg, L, Carlson, K, Christiansen, I, Dahl, IM, Forsberg, K, Brinch, L, Hammerström, J, Johnsen, HE, Knudsen, LM, Linder, O, Mellqvist, U-H, Nesthus, I, Nielsen, JL & Nordic Myeloma Study Group 2006, 'Intensive therapy for multiple myeloma in patients younger than 60 years. Long-term results focusing on the effect of the degree of response on survival and relapse pattern after transplantation', Haematologica, bind 91, nr. 9, s. 1228-33.

Intensive therapy for multiple myeloma in patients younger than 60 years. Long-term results focusing on the effect of the degree of response on survival and relapse pattern after transplantation. / Lenhoff, Stig; Hjorth, Martin; Turesson, Ingemar et al.
I: Haematologica, Bind 91, Nr. 9, 09.2006, s. 1228-33.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

TY - JOUR

T1 - Intensive therapy for multiple myeloma in patients younger than 60 years. Long-term results focusing on the effect of the degree of response on survival and relapse pattern after transplantation

AU - Lenhoff, Stig

AU - Hjorth, Martin

AU - Turesson, Ingemar

AU - Westin, Jan

AU - Gimsing, Peter

AU - Wislöff, Finn

AU - Ahlberg, Lucia

AU - Carlson, Kristina

AU - Christiansen, Ilse

AU - Dahl, Inger Marie

AU - Forsberg, Karin

AU - Brinch, Lorentz

AU - Hammerström, Jens

AU - Johnsen, Hans E

AU - Knudsen, Lene Meldgaard

AU - Linder, Olle

AU - Mellqvist, Ulf-Henrik

AU - Nesthus, Ingerid

AU - Nielsen, Johan Lanng

AU - Nordic Myeloma Study Group

PY - 2006/9

Y1 - 2006/9

N2 - BACKGROUND AND OBJECTIVES: From 1994 to 1997 we conducted a population-based, prospective study on intensive therapy in newly diagnosed symptomatic myeloma patients younger than 60 years, comparing their survival to that of a conventionally treated historic population. Long-term results are presented, including the impact of the degree of response on survival and relapse pattern after transplantation.DESIGN AND METHODS: The prospective population was formed of 397 patients and the historic population of 313 patients. Both populations were calculated to comprise more than 75% of the expected number of new cases.RESULTS: After a median follow-up of 7 years survival was longer in the prospective population than in the historic one (median 60 versus 39 months; p=0.0002). When comparing only patients eligible for intensive therapy the median survival was 63 versus 44 months (p<0.0001). Attaining a complete response was associated with prolonged event-free survival but not overall survival. The pattern of relapse after transplantation was heterogeneous but could be divided into four major groups; insidious, classical, plasmacytoma form and transformed disease. The median survival after relapse was 29 months. The relapse pattern and time to relapse predicted outcome. Patients relapsing with an insidious or classical form of disease with skeletal events only, or after a long lasting first response were likely to respond well to conventional salvage therapy. In contrast, relapse with multiple symptoms, transformed disease or a short duration of first response implied bad prognosis.INTERPRETATION AND CONCLUSIONS: The relapse pattern after autologous transplantation is heterogeneous and response to salvage therapy is variable. The degree of response and event-free survival after transplantation are not reliable surrogate markers for survival.

AB - BACKGROUND AND OBJECTIVES: From 1994 to 1997 we conducted a population-based, prospective study on intensive therapy in newly diagnosed symptomatic myeloma patients younger than 60 years, comparing their survival to that of a conventionally treated historic population. Long-term results are presented, including the impact of the degree of response on survival and relapse pattern after transplantation.DESIGN AND METHODS: The prospective population was formed of 397 patients and the historic population of 313 patients. Both populations were calculated to comprise more than 75% of the expected number of new cases.RESULTS: After a median follow-up of 7 years survival was longer in the prospective population than in the historic one (median 60 versus 39 months; p=0.0002). When comparing only patients eligible for intensive therapy the median survival was 63 versus 44 months (p<0.0001). Attaining a complete response was associated with prolonged event-free survival but not overall survival. The pattern of relapse after transplantation was heterogeneous but could be divided into four major groups; insidious, classical, plasmacytoma form and transformed disease. The median survival after relapse was 29 months. The relapse pattern and time to relapse predicted outcome. Patients relapsing with an insidious or classical form of disease with skeletal events only, or after a long lasting first response were likely to respond well to conventional salvage therapy. In contrast, relapse with multiple symptoms, transformed disease or a short duration of first response implied bad prognosis.INTERPRETATION AND CONCLUSIONS: The relapse pattern after autologous transplantation is heterogeneous and response to salvage therapy is variable. The degree of response and event-free survival after transplantation are not reliable surrogate markers for survival.

KW - Adult

KW - Female

KW - Hematopoietic Stem Cell Transplantation

KW - Humans

KW - Male

KW - Middle Aged

KW - Multiple Myeloma

KW - Salvage Therapy

KW - Survival Rate

KW - Transplantation, Autologous

KW - Treatment Outcome

M3 - Journal article

C2 - 16956822

SN - 0390-6078

VL - 91

SP - 1228

EP - 1233

JO - Haematologica

JF - Haematologica

IS - 9

ER -

Intensive therapy for multiple myeloma in patients younger than 60 years. Long-term results focusing on the effect of the degree of response on survival and relapse pattern after transplantation

Abstract

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