Haematologica 2003 - Supplements

More documents

Recommendations

Info

227 MELPHALAN/PREDNISONE VS. MELPHALAN/DEXAMETASONE AS FIRST LINE TREATMENT IN ELDERLY MULTIPLE MYELOMA PATIENTS J.M.Hernández Martín, E.Golvano, R,García-Sanz, G.Mateo, J.Trujillo, F.J.Fdez-Calvo, J.A.Soler, S.Gardella, F.Carbonell, M.Fontanillas,J.Bladé, J.J.Sánchez, J.F.SanMiguel. PETHEMA Group Melphalan/Prednisone (MP) remains as the standard therapy for elderly Multiple Myeloma (MM) patients. High doses Dexametasone is one of the most active agents in MM. However, there aren’t controlled studies to explore the efficacy and safety of the combination of Dexamethasone with Melphalan. For this reason, the PETHEMA group (Spanish Program for the Therapeutic of Malign Hemopathies) designed a multicentric randomized study in order to compare if Melphalan/Dexametasone (MD) is superior to conventional MP. Response rates, event-free survival (EFS), survival and toxicity have been analyzed. MATHERIALS AND METHODS: Patients: 201 MM patients (proceeding of 27 Spanish Hospitals) > 65 year old or not candidates for autologous transplantation were included in the study. Patients were centrally randomized at diagnosis to receive 6 courses of MP or MD (this with double pulse of Dexametasone). Patients who achieved any grade of response (Complete Response (CR), Partial Response (PR) or Minimal Response (MR) received six additional courses of the same schema; then, those achieving CR or PR went into maintenance therapy with Interpheron alfa-2b plus Dexametasone. Both arms were well balanced according to the most relevant clinicalbiologic disease characteristics. Median of follow-up was 46.8 months. The study was approved for the local ethical committees RESULTS: In 27 cases (10 MP and 17 MD) there were lost of follow-up or major protocol violation. Although the overall response rate was similar in both arms after six courses (MP: 65.4% vs. MD: 65%) (p=0.85) and after twelve courses (MP: 46.1% vs. MD: 46.7%) (p=0.94), the proportion of CR was significantly higher in patients receiving MD than in those treated with MP, and this occurred both after six cycles (MP: 2.6% vs. MD: 9.3%) (p
229 EFFECTIVENESS OF STANDARD CHEMOTHERAPY PROTOCOLS IN MULTIPLE MYELOMA - COMPARATIVE STUDY D. Jawniak A. Dmoszyäska, M. G¢rska, M. Maˆek, A. Gor¥cy, W. Legie† Department of Hematooncology and Bone Marrow Transplantation Center; University Medical School, 20-954 Lublin, Jaczewskiego 8, Poland Introduction: There is known large number of standard chemotherapy protocols in the treatment of multiple myeloma (MM). In this study we evaluated the effectiveness of first line chemotherapy in the treatment of MM and its influence on overall survival. Methods: One hundred and twenty multiple myeloma patients (61 female and 59 male) treated in Department of Hematooncology in Lublin (Poland) between 1992 and 2001 were enrolled in this study. Patients age ranged from 38 to 79 years (mean value 60.6). In our study group the predominant type of disease was classic multiple myeloma with IgG monoclonal proteins (82,2%). The response for treatment was assessed according to EBMT criteria. Patients were qualified for particular type of chemotherapy protocol according to generally used criteria (i.e. age). Results: The best response was observed after VAD protocol - 60% of patients acquired complete remission (CR) or partial remission (PR). Good response (CR+PR) was obtained in 46% of patients after VMBCP protocol, but only in 10,7% of patients after MP protocol. In 16,7% of patients partial remission was observed after single intravenous infusion of cyclophosphamide and melfalan as transplantation protocol according to Palumbo et all. After chemotherapy with Ida+Dex we noticed only stabilization of disease parameters. In more than 50% of patients we studied also the expression of adhesion molecules on multiple myeloma cells using flow cytometry technique. The expression of fibronectin receptor CD49e (VLA-5) and laminin receptor CD49f (VLA-6) significantly correlated with effects of chemotherapy. In patients with negative expression of CD49e, the percentage of CR+PR was 47.2, while in group with positive CD49e expression, the percentage of CR+PR was 27.6. Considering the positive and negative expression of CD49f, the percentage of good response was adequately 47.4 vs 25.9. No significant differences in follow-up time between particular treatment protocols were found. In group with VAD, VMBCP and MP protocol follow-up time was adequately 23.6 and 35 months. Statistically significant shorter follow-up time (23.6 months) was observed in patients with positive expression of CD49d (VLA-4) vs 30.8 months in patients with negative CD49d expression. Conclusion: On the basis of our study we confirmed that none of evaluated first line chemotherapy protocols significantly prolonged overall survival. We found that the high expression of CD49d on the surface of myeloma cells may be considered as poor prognosistic factor. 230 Interim Analysis of Randomized Trial “4W“ of Czech Myeloma Group: Maintenance Therapy Interferon Alpha or Sequential Maintenance Therapy Interferon Alpha and Dexametazonea after High-Dose Chemotherapy and Peripheral Blood Stem Cell Transplantation in Newly Diagnosed Patients with Multiple Myeloma. Hajek R., Scudla V., Krejci M., Bacovsky J., Schützová M., Koza V., Tothova E., Papajik T., Franková H., Stavarová Y., Lehanka F., Vranova M., Kessler P., Pozdenova V., Walterova L., Stefanek I., Novosadová L., Vytrasova M., Meluzinová I., Hausdorf P., Seifertova N., Sumna E. , Dušek L., Svobodnik A., Vorlíček J a Adam Z For the Czech Myeloma Group; Office: Masaryk University Hospital Jihlavska 20, Brno 639 00, Czech Republic Optimal maintenance therapy after autologous transplantation is unclear. In order to assess the role of interferon alfa (IFN) and IFN plus dexamethasone (IFN/DEX) as the maintenance therapy after ASCT, 246 previously untreated patients with multiple myeloma (MM) were enrolled to trial 4W from 1996 to 2002. Patients received primary therapy with four cycles of VAD regimen (vincristine, doxorubicin, dexamethasone) followed by mobilization with cyclophosphamide 5g/m2 and G-CSF 10 µg/kg. A conditioning regimen with melphalan 200mg/m2 was used for first and second transplantation. The later was indicated only in patients who did not achieve a good remission (>75% reduction of M-component). After transplantation patients were randomized to two arms of maintenance therapy: IFN 3 x 106 units three times weekly s.c. or the same dose of IFN in alternating cycles with dexamethasone 40 mg in days 1-4, 10-13, 20-23. Data of 183 randomized patients (pts.) to 31st August 2002 were evaluated in this analysis. One month after transplantation 6 % of pts. achieved complete remission (M-component 0% and negative immunofixation), overall response rate was 88 % (>50 % reduction of M-component). Transplant related mortality at day +100 was 2.0 %. All 183 randomized patients received the maintenance therapy, 94 pts. in the IFN arm and 89 patients in the IFN/DEX arm. Median of EFS for all 183 pts. was 42.1 months and median of OS was not yet achieved. In analysis, the OS and EFS curves have shown no significant statistical differences between the IFN and IFN/DEX groups (44.6 vs. 35.5 months; p = 0.913 for EFS), although difference is 9 months. Data from more than 180 randomized patients (interim analysis to 31st August 2002) will be available for comparison of the two types of maintenance therapy after autologous transplantation. Substantial number of pts. in IFN group (23% vs. 13% in ID group) premature finished MT due to IFN toxicity. 231 Quality of Life(QOL) comparison at 6 months between VAD based treatment and standard chemotherapy for Multiple Myeloma(MM) Crofts S E, Twine T J , Smith A G Haematology Departement, Southampton University Hopsitals NHS Trust, Southampton General Hospiatl, Southampton SO16 6YD, United Kingdom Data on Quality of Life (QOL) measurement in Multiple Myeloma (MM) remain limited. QOL is important to patients given the varied treatment options available in myeloma at diagnosis and relapse. This study sought to confirm that treatment results in improved QOL and to assess differences in QOL for S190
Page 1 and 2:
Focussed Symposia Arsenic trioxide
Page 3 and 4:
assess whether such a program will
Page 5 and 6:
The overall response rate was noted
Page 7 and 8:
Figure 5A Table 1: VEL + THAL for R
Page 9 and 10:
naturally occurring OPG. Present tr
Page 11 and 12:
0.505). Finally, the multiple event
Page 13 and 14:
CLINICOPATHOLOGICAL DEFINITION OF W
Page 15 and 16:
Plenary Sessions 1. Development of
Page 17 and 18:
clonotypic IgH VDJ signature confir
Page 19 and 20:
can be considered as two entities,
Page 21 and 22:
immunofluorescence staining for DKK
Page 23 and 24:
P2.3 DEVELOPMENT OF A MULTIPLE MYEL
Page 25 and 26:
P2.5 MOLECULAR CYTOGENETICS OF MYEL
Page 27 and 28:
clear that the biggest challenge fo
Page 29 and 30:
esponse and have demonstrated that
Page 31 and 32:
variable region of the idiotypic im
Page 33 and 34:
4. From MGUS to symptomatic MM Fig.
Page 35 and 36:
(MRI); some have claimed that level
Page 37 and 38:
P4.5 CYTOKINES IN MGUS: THERAPEUTIC
Page 39 and 40:
preventing phosphorylation of p70S6
Page 41 and 42:
transducing component of the interl
Page 43 and 44:
survive initial drug exposure and a
Page 45 and 46:
quiescent counterpart, the human um
Page 47 and 48:
transcriptional activity of NF-êB;
Page 49 and 50:
manifestations and anomalous protei
Page 51 and 52:
P7.4 ROLE OF SERUM FREE LIGHT CHAIN
Page 53 and 54:
P7.6 IMMUNOPHENOTYPIC INVESTIGATION
Page 55 and 56:
presumably through the circulation,
Page 57 and 58:
9. Chemotherapy, maintenance treatm
Page 59 and 60:
stratified according to their antim
Page 61 and 62:
explore higher doses of zoledronic
Page 63 and 64:
initial therapy. However, the role
Page 65 and 66:
P10.2.2 SINGLE VERSUS TANDEM HIGH D
Page 67 and 68:
With a median follow-up of 38 month
Page 69 and 70:
cells could be harvested following
Page 71 and 72:
11. What is the role of allogeneic
Page 73 and 74:
found that 75% of patients who were
Page 75 and 76:
patients with responsive disease 3
Page 77 and 78:
9. Giralt S, Estey E, Albitar M, et
Page 79 and 80:
Badros A, Barlogie B, Siegel E, et
Page 81 and 82:
Figure 3b. Event-free Survival 4-Ye
Page 83 and 84:
improve patient outcome in MM. Impo
Page 85 and 86:
myeloma and in 40% of previously un
Page 87 and 88:
degrade OPG in the same way as myel
Page 89 and 90:
P12.2.5 MONOCLONAL ANTIBODY THERAPY
Page 91 and 92:
myeloma. Blood 2001; 98:210-216. 6.
Page 93 and 94:
MHC molecules, in effectively prese
Page 95 and 96:
mice demonstrate that class II-spec
Page 97 and 98:
detected in 293 and NIH3T3 cells. S
Page 99 and 100:
hypothesis that (1) CCND1 and FGFR3
Page 101 and 102:
patient samples. In addition, the p
Page 103 and 104:
016 NEUTRAL ENDOPEPTIDASE (CD10) KN
Page 105 and 106:
2. Genetic heterogeneity in MM: imp
Page 107 and 108:
evidence from two t(11;14) cases wh
Page 109 and 110:
immunoglobulin heavy chain (IgH) lo
Page 111 and 112:
034 Instability of Pericentromeric
Page 113 and 114:
clusters were found, the first was
Page 115 and 116:
MGUS but most likely not crucial fo
Page 117 and 118:
Objective: To compare the impact on
Page 119 and 120:
4 patients had MMSET/IgH but did no
Page 121 and 122:
and clonal PC from MGUS, MM and PCL
Page 123 and 124:
059 VEGF receptor expresion in Mult
Page 125 and 126:
two HLA-A2+ myeloma patients with C
Page 127 and 128:
molecules expressed on the surface
Page 129 and 130:
Recognition of these antigens appea
Page 131 and 132:
Diagnosis requires a single area of
Page 133 and 134:
081 Incidence of solid tumors in co
Page 135 and 136:
Growth Factor (VEGF), Hepatocyte Gr
Page 137 and 138:
PC-AI levels of MGUS and SMM patien
Page 139 and 140:
093 The predominant pathway of tran
Page 141 and 142:
was associated with I.V. line, whil
Page 143 and 144:
103 Vascular amyloidosis induces se
Page 145 and 146:
5. Signal transduction pathways and
Page 147 and 148: integrin in IGF-1-triggered MM cell
Page 149 and 150: 118 IL-6- Induced Phosphorylation o
Page 151 and 152: 123 THE IGF/IGF-1R SYSTEM IS A MAJO
Page 153 and 154: human myeloma cell line (HMCL) to a
Page 155 and 156: ligation or dexamethasone (Georgii-
Page 157 and 158: 6. Role of microenvironment 6.1 Cel
Page 159 and 160: 141 Human myeloma cells adhere to f
Page 161 and 162: 145 STUDY OF BONE MARROW ANGIOGENES
Page 163 and 164: patients, the growth of primary mye
Page 165 and 166: tibia (con=49.1±0.7mg/cm2 vs 5T2=4
Page 167 and 168: 157 The Nitrogen-Containing Bisphos
Page 169 and 170: 7. New prognostic criteria for clas
Page 171 and 172: atio of >3. This system has subdivi
Page 173 and 174: Patient 1 (IgG/κ);IgG - 16.5 days,
Page 175 and 176: 176 Pro-inflammatory and angiogenic
Page 177 and 178: 180 Clinical study on the bone lesi
Page 179 and 180: 7.2 Imaging studies 185 99mTc-MIBI
Page 181 and 182: 189 Factors Predicting Occult Spina
Page 183 and 184: vivo detected resonances was invest
Page 185 and 186: Support Unit (CTSU) with flexibilit
Page 187 and 188: (β2m) & C reactive protein (CRP).
Page 189 and 190: plasmids carrying the clonotypic in
Page 191 and 192: newly diagnosed multiple myeloma as
Page 193 and 194: 216 Transgenic expression of Myc an
Page 195 and 196: 221 Prolonged survival in the 5T2MM
Page 197: 9. Chemotherapy, maintenance, treat
Page 201 and 202: 234 Melphalan and Dexamethasone- Is
Page 203 and 204: Methods. We investigated the VECD p
Page 205 and 206: 9.2 Renal complications. 243 MERIT
Page 207 and 208: cost of SRE-related care was $10,24
Page 209 and 210: those with Hb >13 g/dL. Analysis of
Page 211 and 212: sustained response, lasting from 52
Page 213 and 214: proportion of bone abnormality. IgD
Page 215 and 216: disease. The lack of response to in
Page 217 and 218: yielding a median of 3x106/kg CD34
Page 219 and 220: patients(pts) aged ≥60 yrs. We co
Page 221 and 222: PBSC mobilizing regimen utilizing C
Page 223 and 224: their leukocytes and platelets. No
Page 225 and 226: 25 Gy to marrow. The tracer dose wa
Page 227 and 228: non-CR after the first transplant a
Page 229 and 230: 296 PERIPHERAL BLOOD STEM CELL TRAN
Page 231 and 232: References Effect of dose-intensive
Page 233 and 234: with cyclosporine A and methotrexat
Page 235 and 236: 11.Role of novel therapies targetin
Page 237 and 238: 312 Thalidomide as Rescue of Relaps
Page 239 and 240: patients, light chain in 1 patients
Page 241 and 242: platelets of 207 (76-402), B2M of 3
Page 243 and 244: 325 Low Dose Thalidomide plus Dexam
Page 245 and 246: in 5 pts (11%), M protein decreased
Page 247 and 248: time from diagnosis was 3.7 years a
Page 249 and 250:
339 Thalidomide, Clarithromycin and
Page 251 and 252:
344 COMBINATION OF THALIDOMIDE, DEX
Page 253 and 254:
experienced early death during the
Page 255 and 256:
untreated patients with high tumor
Page 257 and 258:
357 Thalidomide protects endothelia
Page 259 and 260:
362 EOSINOPHILIA IS A VERY COMMON F
Page 261 and 262:
11.5 CC 4047, PS 341 and arsenic tr
Page 263 and 264:
without chromosome 13. Mean IC50 fo
Page 265 and 266:
myeloma patients. Phase I data indi
Page 267 and 268:
11.6 Other drugs 380 EFFECT OF STI5
Page 269 and 270:
significant inhibition of cell prol
Page 271 and 272:
which acts to prevent the synthesis
Page 273 and 274:
of B and its metabolites, however,
Page 275 and 276:
and 10 months after start of therap
Page 277 and 278:
terminal kinase (JNK) pathway which
Page 279 and 280:
lymphocytes was tested by Ellispot.
Page 281 and 282:
411 Dendritic Cell-Based Idiotype V
Page 283 and 284:
Author Index Abe M 74 160 Abelman W
Page 285 and 286:
De La Serna J 291 De Laurenzi A P11
Page 287 and 288:
Hull DR 338 Hullen C P10.2.1 Humes
Page 289 and 290:
Morra E 249 280 359 Morris CM 226 M
Page 291 and 292:
Siegel D 70 115 250 Sierra J 304 30
show all

Haematologica 2003 - Supplements

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?