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Myeloma

Clinical outcomes with intensive therapy for patients with primary resistant multiple myeloma

Summary:

Clinical outcomes were evaluated in 89 consecutive patients with multiple myeloma that had not responded to dexamethasone-based primary therapy, who received early intensive therapy supported by autologous stem cell transplantation. Results were compared with those of 45 comparable patients who refused or were unable to receive intensive treatment for socioeconomic reasons. Following high-dose therapy, the response rate was 69% including 16% with CR. Survival of 14 patients with CR (median >7.0 years) was significantly longer than those of 47 patients with PR (median 4.5 years) or of 28 patients who remained NR (median 2.2 years). CR occurred in 43% of patients with serum myeloma protein <1.5 gm/dl, in contrast to 7% of those with higher values, a finding similar to that observed previously for patients consolidated in PR. No prognostic factor was associated with PR and, in view of the high frequencies of PR or CR, all patients with primary resistant myeloma should be considered for early intensive therapy. The limited improvement of lifespan and disease-free survival for those in PR indicated the need for further treatment to achieve CR, the major surrogate marker for long survival.

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Acknowledgements

We thank Rose Guevara for careful preparation of the manuscript. This work was supported by Lucille Murchison and Kay Laro research funds.

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Correspondence to R Alexanian.

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Alexanian, R., Weber, D., Delasalle, K. et al. Clinical outcomes with intensive therapy for patients with primary resistant multiple myeloma. Bone Marrow Transplant 34, 229–234 (2004). https://doi.org/10.1038/sj.bmt.1704562

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