Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Bourhis, JH; Bouko, Y; Koscielny, S; Bakkus, M; Greinix, H; Derigs, G; Salles, G; Feremans, W; Apperley, J; Samson, D; Björkstrand, B; Niederwieser, D; Gahrton, G; Pico, JL; Goldschmidt, H; European Group for Blood and Marrow Transplantation.
Relapse risk after autologous transplantation in patients with newly diagnosed myeloma is not related with infused tumor cell load and the outcome is not improved by CD34+ cell selection: long term follow-up of an EBMT phase III randomized study.
Haematologica. 2007; 92(8): 1083-1090.
Doi: 10.3324/haematol.10535
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- Co-Autor*innen der Med Uni Graz
- Greinix Hildegard
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- Abstract:
- This European Group for Blood and Marrow Transplantation (EBMT) multicentre randomized phase III study was designed to assess the safety and efficacy of CD34+ selection in newly diagnosed myeloma patients undergoing autologous transplantation. One hundred and eleven patients responsive to initial chemotherapy were randomized to receive CD34+ selected (arm A) or unselected PBPC (arm B) after conditioning with high-dose melphalan and TBI. ASO-PCR was used to assess purging efficacy and reinfused tumor load. Tumor load could be assessed in 59 patients. CD34+ selection gave a median tumor cell depletion of 2.2 logs (0.77-5.96). No tumor cells were detected in products infused in 17/26 (A) and 5/33 (B) patients. The five year overall survival (OS), event free survival (EFS) and relapse rate (RR) were 51%, 20% and 80% in arm A and 45%, 18% and 80% in arm B respectively with no significant difference between the two groups. Thirteen patients in arm A and 2 in arm B experienced episodes of serious early infection (p=0.02). There were 3 early transplant related deaths in A but none in B. Despite significant tumor cell reduction, CD34+ selection does not reduce RR and increases the risk of severe post-transplant infections. There was also no difference in RR between patients in either arm who received grafts with detectable tumor cells and those receiving grafts with no detectable tumor cells, suggesting that reinfused tumor cells may not be the main cause of relapse after autologous transplant in myeloma.
- Find related publications in this database (using NLM MeSH Indexing)
- Adolescent -
- Adult -
- Aged -
- Antigens, CD34 - analysis
- Antineoplastic Combined Chemotherapy Protocols - administration & dosage Antineoplastic Combined Chemotherapy Protocols - therapeutic use
- Bone Marrow Purging - methods
- Dexamethasone - administration & dosage
- Disease-Free Survival -
- Doxorubicin - administration & dosage
- Female -
- Follow-Up Studies -
- Humans -
- Male -
- Middle Aged -
- Multiple Myeloma - drug therapy Multiple Myeloma - mortality Multiple Myeloma - surgery
- Peripheral Blood Stem Cell Transplantation - mortality Peripheral Blood Stem Cell Transplantation - statistics & numerical data
- Postoperative Complications - epidemiology
- Prognosis -
- Recurrence -
- Risk -
- Survival Analysis -
- Survival Rate -
- Transplantation Conditioning - methods
- Transplantation, Autologous - statistics & numerical data
- Treatment Outcome -
- Vincristine - administration & dosage
- Find related publications in this database (Keywords)
- myeloma
- autologous transplantation
- CD34(+) selection