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Induction therapy and stem cell mobilization in patients with newly diagnosed multiple myeloma.

Ria R, Reale A, Solimando AG, Mangialardi G, Moschetta M, Gelao L, Iodice G, Vacca A - Stem Cells Int (2012)

Bottom Line: The introduction into clinical practice of novel agents, such as the proteasome inhibitor bortezomib and the immunomodulatory derivatives (IMiDs) thalidomide and lenalidomide, has significantly contributed to major advances in MM therapy and prognosis.Only 7 patients were in stage B (renal failure).In mobilization procedure, the patients received cyclophosphamide and granulocyte colony-stimulating factor (G-CSF).

View Article: PubMed Central - PubMed

Affiliation: Section of Internal Medicine and Clinical Oncology, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Policlinico, Piazza Giulio Cesare 11, I-70124 Bari, Italy.

ABSTRACT
Autologous stem cell transplantation (ASCT) is considered the standard therapy for younger patients with newly diagnosed symptomatic multiple myeloma (MM). The introduction into clinical practice of novel agents, such as the proteasome inhibitor bortezomib and the immunomodulatory derivatives (IMiDs) thalidomide and lenalidomide, has significantly contributed to major advances in MM therapy and prognosis. These novel agents are incorporated into induction regimens to enhance the depth of response before ASCT and further improve post-ASCT outcomes. Between January 2000 and November 2011, 65 patients with MM were transplanted in the Department of Biomedical Science and Clinical Oncology at the University of Bari. According to Durie-Salmon, 60 patients had stage III of disease and 5 stage II. Only 7 patients were in stage B (renal failure). Induction regimens that were administered in two or more cycles were VAD (vincristine, adriamycin, and dexamethasone), Thal-Dex (thalidomide, dexamethasone), Len-Dex (lenalidomide, dexamethasone), Vel-Dex (bortezomib, dexamethasone), VTD (bortezomib, thalidomide, and dexamethasone), and PAD (bortezomib, pegylated liposomal doxorubicin, and dexamethasone). In mobilization procedure, the patients received cyclophosphamide and granulocyte colony-stimulating factor (G-CSF). The number of cells collected through two or more leukapheresess, response after induction, and toxicity were evaluated to define the more adequate up-front induction regimen in transplantation-eligible MM patients.

No MeSH data available.


Related in: MedlinePlus

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Mentions: In VAD- and Vel-treated patients, a significantly higher CD34+ collection was obtained: 8.5 ± 1.01 × 106 CD34+/Kg body weight (bw) and 7.5 ± 1.08 × 106 CD34+/Kg bw, respectively, versus 4.11 ± 0.60 × 106 CD34+/Kg bw in lenalidomide-treated patients (P = 0.01 and P < 0.005) (Figure 1(a)). The percentage of patients who reached the minimum collection target after two leukaphereses was higher in those treated with VAD or Vel (86% and 84%, resp.) than those treated with lenalidomide (56%) (P < 0.01). The apheresis' mean volume after plasma detraction was of 56 ± 16 mL in VAD- and Vel-treated patients and 53 ± 13 mL in lenalidomide treated patients.


Induction therapy and stem cell mobilization in patients with newly diagnosed multiple myeloma.

Ria R, Reale A, Solimando AG, Mangialardi G, Moschetta M, Gelao L, Iodice G, Vacca A - Stem Cells Int (2012)

© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3369512&req=5

Mentions: In VAD- and Vel-treated patients, a significantly higher CD34+ collection was obtained: 8.5 ± 1.01 × 106 CD34+/Kg body weight (bw) and 7.5 ± 1.08 × 106 CD34+/Kg bw, respectively, versus 4.11 ± 0.60 × 106 CD34+/Kg bw in lenalidomide-treated patients (P = 0.01 and P < 0.005) (Figure 1(a)). The percentage of patients who reached the minimum collection target after two leukaphereses was higher in those treated with VAD or Vel (86% and 84%, resp.) than those treated with lenalidomide (56%) (P < 0.01). The apheresis' mean volume after plasma detraction was of 56 ± 16 mL in VAD- and Vel-treated patients and 53 ± 13 mL in lenalidomide treated patients.

Bottom Line: The introduction into clinical practice of novel agents, such as the proteasome inhibitor bortezomib and the immunomodulatory derivatives (IMiDs) thalidomide and lenalidomide, has significantly contributed to major advances in MM therapy and prognosis.Only 7 patients were in stage B (renal failure).In mobilization procedure, the patients received cyclophosphamide and granulocyte colony-stimulating factor (G-CSF).

View Article: PubMed Central - PubMed

Affiliation: Section of Internal Medicine and Clinical Oncology, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Policlinico, Piazza Giulio Cesare 11, I-70124 Bari, Italy.

ABSTRACT
Autologous stem cell transplantation (ASCT) is considered the standard therapy for younger patients with newly diagnosed symptomatic multiple myeloma (MM). The introduction into clinical practice of novel agents, such as the proteasome inhibitor bortezomib and the immunomodulatory derivatives (IMiDs) thalidomide and lenalidomide, has significantly contributed to major advances in MM therapy and prognosis. These novel agents are incorporated into induction regimens to enhance the depth of response before ASCT and further improve post-ASCT outcomes. Between January 2000 and November 2011, 65 patients with MM were transplanted in the Department of Biomedical Science and Clinical Oncology at the University of Bari. According to Durie-Salmon, 60 patients had stage III of disease and 5 stage II. Only 7 patients were in stage B (renal failure). Induction regimens that were administered in two or more cycles were VAD (vincristine, adriamycin, and dexamethasone), Thal-Dex (thalidomide, dexamethasone), Len-Dex (lenalidomide, dexamethasone), Vel-Dex (bortezomib, dexamethasone), VTD (bortezomib, thalidomide, and dexamethasone), and PAD (bortezomib, pegylated liposomal doxorubicin, and dexamethasone). In mobilization procedure, the patients received cyclophosphamide and granulocyte colony-stimulating factor (G-CSF). The number of cells collected through two or more leukapheresess, response after induction, and toxicity were evaluated to define the more adequate up-front induction regimen in transplantation-eligible MM patients.

No MeSH data available.


Related in: MedlinePlus