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Myeloma

Alpha-interferon maintenance treatment is associated with improved survival after high-dose treatment and autologous stem cell transplantation in patients with multiple myeloma: a retrospective registry study from the European Group for Blood and Marrow Transplantation (EBMT)

Bone Marrow Transplantation volume 27, pages 511–515 (2001)Cite this article

Abstract

The purpose of this study was to evaluate the effect of alpha-IFN maintenance treatment after autologous stem cell transplantation (ASCT) for multiple myeloma in a retrospective registry analysis. 473 patients with multiple myeloma who received IFN maintenance treatment ASCT were compared with 419 patients who did not receive IFN-treatment. Patients who were evaluable for response and in complete or partial remission at 6 months after ASCT were eligible, after excluding patients with graft failure. Cox proportional hazards assumptions were checked and handled by stratification. The prognostic variables unevenly distributed between the two groups were statistically corrected for in the Cox analysis. 391 patients reached complete remission (CR) after ASCT (203 in the IFN group and 188 in the no-IFN group) and 501 were in partial remission (PR, IFN 270, no-IFN 231). Overall survival (OS) and progression-free survival (PFS) were significantly better in the IFN-group (OS, 78 vs 47 months, P = 0.007, and PFS, 29 vs 20 months, P = 0.006, respectively). The difference in OS and PFS was most strongly pronounced in the PR patients. 209 patients have died (IFN, 84; no-IFN, 125). Progressive myeloma was the cause of death in 94% of the IFN-treated patients and in 83% of the no-IFN group (P = NS). Thus, IFN maintenance treatment after ASCT was associated with better OS and PFS. Treatment seemed to be most beneficial in patients who did not achieve CR. The difference in median survival was as long as 2.5 years, and although part of this difference is attributable to differences in other prognostic factors, it might justify possible differences in quality-of-life due to adverse effects of interferon treatment. Bone Marrow Transplantation (2001) 27, 511–515.

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References

  1. Björkstrand B, Ljungman P, Svensson H et al. Allogeneic bone marrow transplantation versus autologous stem cell transplantation in multiple myeloma – a retrospective case-matched study from the European Group for Blood and Marrow Transplantation Blood 1996 88: 4711–4718

    Google Scholar 

  2. Attal M, Harousseau JL, Stoppa AM et al. A prospective randomized trial of autologous bone marrow transplantation and chemotherapy in multiple myeloma N Engl J Med 1996 335: 91–97

    Article  CAS  Google Scholar 

  3. Mellstedt H, Aahre A, Björkholm M et al. Interferon therapy in myelomatosis Lancet 1979 1: 245–247

    Article  CAS  Google Scholar 

  4. Mandelli F, Rees JKH, Gorin NC, Prentice HG . Post-remission treatment in acute myeloid leukemia: chemotherapy or autologous or allogeneic bone marrow transplantation Haematologica 1990 75: 203–211

    CAS  PubMed  Google Scholar 

  5. Cooper MR, Dear K, McIntyre R et al. A randomized clinical trial comparing melphalan/prednisolone with or without interferon alfa-2b in newly diagnosed patients with multiple myeloma: a Cancer and Leukemia Group B study J Clin Oncol 1993 11: 155–160

    Article  CAS  Google Scholar 

  6. Österborg A, Björkholm M, Björeman M et al. Natural interferon-α in combination with melphalan/prednisone versus melphalan/prednisone in the treatment of multiple myeloma stages II and III: a randomized study from the Myeloma Group of Central Sweden Blood 1993 81: 1428–1434

    PubMed  Google Scholar 

  7. Salmon SE, Crowley JJ, Grogan TM et al. Combination chemotherapy, glucocorticoids and interferon alfa in the treatment of multiple myeloma: a Southwest Oncology Group study J Clin Oncol 1994 12: 2405–2414

    Article  CAS  Google Scholar 

  8. Ludwig H, Cohen AM, Polliack A et al. Interferon-alpha for induction and maintenance in multiple myeloma: results of two multicentre randomized trials and summary of other studies Ann Oncol 1995 6: 467–476

    Article  CAS  Google Scholar 

  9. Hjorth M, Westin J, Dahl IMS et al. Interferon-α2b added to melphalan-prednisolone for initial and maintenance therapy in multiple myeloma: a randomized, controlled trial Ann Intern Med 1996 124: 212–222

    Article  CAS  Google Scholar 

  10. Bladé J, San Miguel JF, Escudero ML et al. Maintenance treatment with interferon alpha-2b in multiple myeloma: a prospective randomized study from PETHEMA (Program for the Study and Treatment of Hematological Malignancies, Spanish Society of Hematology) Leukemia 1998 12: 1144–1148

    Article  Google Scholar 

  11. Byrne JL, Carter GI, Bienz N et al. Adjuvant alpha-interferon improves complete remission rates following allogeneic transplantation for multiple myeloma Bone Marrow Transplant 1998 22: 639–644

    Article  CAS  Google Scholar 

  12. Attal M, Huguet F, Schlaifer D et al. Intensive combined therapy for previously untreated aggressive myeloma Blood 1992 79: 1130–1136

    CAS  Google Scholar 

  13. Harousseau J-L, Attal M, Divine M et al. Autologous stem cell transplantation after first remission induction treatment in multiple myeloma: a report of the French registry on autologous transplantation in multiple myeloma Blood 1995 85: 3077–3085

    CAS  Google Scholar 

  14. Alegre A, Díaz-Mediavilla J, San-Miguel J et al. Autologous peripheral blood stem cell transplantation for multiple myeloma: a report of 259 cases from the Spanish registry Bone Marrow Transplant 1998 21: 133–140

    Article  CAS  Google Scholar 

  15. Cunningham D, Powles R, Malpas J et al. A randomized trial of maintenance interferon following high-dose chemotherapy in multiple myeloma: long-term follow-up results Br J Haematol 1998 102: 495–502

    Article  CAS  Google Scholar 

  16. Mandelli F, Avvisati G, Amadori S et al. Maintenance treatment with recombinant interferon alfa-2b in patients with multiple myeloma responding to conventional induction chemotherapy N Engl J Med 1990 322: 1430–1434

    Article  CAS  Google Scholar 

  17. Browman GE, Rubin S, Walker L et al. Interferon α-2b (IFN) maintenance therapy prolongs progression free and overall survival in plasma cell myeloma (PCM) Proc Am Soc Clin Oncol 1994 13: 408

    Google Scholar 

  18. Westin J, Rödjer S, Turesson I et al. Interferon alfa-2b versus no maintenance therapy during the plateau phase in multiple myeloma: a randomized study Br J Haematol 1995 89: 561–568

    Article  CAS  Google Scholar 

  19. Peest D, Deicher H, Coldwey R et al. A comparison of polychemotherapy and melphalan prednisolone for primary remission induction, and interferon-alpha for maintenance treatment, in multiple myeloma: a prospective trial of the German Myeloma Treatment Group Eur J Cancer 1995 31: 146–151

    Article  Google Scholar 

  20. Drayson MT, Chapman CE, Dunn JA et al. MRC trial of alpha2b-interferon maintenance therapy in first plateau phase of multiple myeloma. MRC Working Party on Leukaemia in Adults Br J Haematol 1998 101: 195–202

    Article  CAS  Google Scholar 

  21. Ludwig H, Fritz E, Neuda J, Durie BG . Patient preferences for interferon alfa in multiple myeloma J Clin Oncol 1997 15: 1672–1679

    Article  CAS  Google Scholar 

  22. Zee B, Cole B, Li T et al. Quality-adjusted time without symptoms or toxicity analysis of interferon maintenance in multiple myeloma J Clin Oncol 1998 16: 2834–2839

    Article  CAS  Google Scholar 

  23. Wisløff F . Quality of life and patients’ perception in interferon treated myeloma patients VII International Multiple Myeloma Workshop Stockholm 1999 100

    Google Scholar 

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Authors and Affiliations

  1. Dept of Medicine, Karolinska Institute and Huddinge Hospital, Huddinge, Sweden

    B Björkstrand, H Svensson, P Ljungman & G Gahrton

  2. Dept of Medicine, University of Heidelberg, Germany

    H Goldschmidt

  3. Dept of Haematology, Imperial College at the Hammersmith Hospital, London, UK

    J Apperley

  4. Dept of Hematology, University ‘La Sapienza’, Rome, Italy

    F Mandelli

  5. Dept of Haematology, Addenbrooke's Hospital, Cambridge, UK

    R Marcus

  6. Dept of Hematology, University Hospital Gasthuisberg, Leuven, Belgium

    M Boogaerts

  7. Dept of Hematology, Hospital de la Princesa, Madrid, Spain

    A Alegre

  8. Dept of Medicine, University Central Hospital, Turku, Finland

    K Remes

  9. Daniel den Hoed Cancer Center, Rotterdam, The Netherlands

    JJ Cornelissen

  10. Dept of Hematology, Hospital Clinic, Barcelona, Spain

    J Bladé

  11. Dept of Hematology, University Hospital, Lund, Sweden

    S Lenhoff

  12. Hospital Universitario, Santander, Spain

    A Iriondo

  13. Dept of Medicine, University Hospital, Uppsala, Sweden

    K Carlson

  14. Dept of Medicine, University Central Hospital, Helsinki, Finland

    L Volin

  15. Dept of Haematology, Radcliffe Hospital, Oxford, UK

    T Littlewood

  16. Dept of Haematology, University College Hospital, London, UK

    AH Goldstone

  17. Dept of Hematology, Hospital Clínico, Salamanca, Spain

    J San Miguel

  18. Div of Hematology, University Hospital St Radboud, Nijmegen, The Netherlands

    A Schattenberg

Authors
  1. B Björkstrand
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  2. H Svensson
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  11. JJ Cornelissen
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  12. J Bladé
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  15. K Carlson
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  16. L Volin
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  18. AH Goldstone
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  19. J San Miguel
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  20. A Schattenberg
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  21. G Gahrton
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on behalf of the EBMT Myeloma Subcommittee

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Björkstrand, B., Svensson, H., Goldschmidt, H. et al. Alpha-interferon maintenance treatment is associated with improved survival after high-dose treatment and autologous stem cell transplantation in patients with multiple myeloma: a retrospective registry study from the European Group for Blood and Marrow Transplantation (EBMT). Bone Marrow Transplant 27, 511–515 (2001). https://doi.org/10.1038/sj.bmt.1702826

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