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Attainment of at least a very good partial response after induction treatment is an important surrogate of longer survival for multiple myeloma.

Department of Haematology, Singapore General Hospital, Outram Road, Singapore, Republic of Singapore.
Bone marrow transplantation (Impact Factor: 3). 02/2010; 45(11):1625-30. DOI: 10.1038/bmt.2010.25
Source: PubMed

ABSTRACT The importance of achieving a very good partial response or better (≥VGPR) after induction treatment of myeloma has traditionally only been discussed in the context of high-dose therapy with auto-SCT (HDT/auto-SCT). Of late, the advent of novel agents for induction treatment has resulted in improved CR and VGPR rates, which are comparable with those observed with HDT/auto-SCT. We show that in an unselected group of 179 myeloma patients with diverse baseline characteristics, and treated with different modern induction regimens within a single institution, the attainment of ≥VGPR with or without HDT/auto-ASCT represents a major surrogate marker of better clinical outcomes. On the basis of a 1-year landmark survival analysis, patients achieving ≥VGPR enjoy a significantly longer PFS, which translated to a longer OS. Superseding the adverse effects of advanced age, high International Staging System (ISS) stage, adverse cytogenetics and independent of the transplant status, the attainment of ≥VGPR emerged as the single most significant predictor of long-term survival on multivariate analysis.

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May 15, 2014