Single versus tandem high-dose melphalan followed by autologous blood stem cell transplantation in multiple myeloma

• Verfasst von: Mai, Elias K. [VerfasserIn]
• Verfasst von: Bertsch, Uta [VerfasserIn]
• Verfasst von: Egerer, Gerlinde [VerfasserIn]
• Verfasst von: Ho, Anthony Dick [VerfasserIn]
• Verfasst von: Hillengaß, Jens [VerfasserIn]
• Verfasst von: Raab, Marc-Steffen [VerfasserIn]
• Verfasst von: Goldschmidt, Hartmut [VerfasserIn]
• Titel: Single versus tandem high-dose melphalan followed by autologous blood stem cell transplantation in multiple myeloma
• Titelzusatz: long-term results from the phase III GMMG-HD2 trial
• Verf.angabe: Elias K. Mai, Axel Benner, Uta Bertsch, Peter Brossart, Annette Hänel, Volker Kunzmann, Ralph Naumann, Kai Neben, Gerlinde Egerer, Anthony D. Ho, Jens Hillengass, Marc S. Raab, Andreas Neubauer, Astrid Peyn, Yon-Dschun Ko, Norma Peter, Christof Scheid and Hartmut Goldschmidt
• E-Jahr: 2016
• Jahr: 17 March 2016
• Umfang: 11 S.
• Fussnoten: Gesehen am 14.08.2019
• Titel Quelle: Enthalten in: British journal of haematology
• Ort Quelle: Oxford [u.a.] : Wiley-Blackwell, 1955
• Jahr Quelle: 2016
• Band/Heft Quelle: 173(2016), 5, Seite 731-741
• ISSN Quelle: 1365-2141
• DOI: doi:10.1111/bjh.13994
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: melphalan
• Sach-SW: myeloma
• Sach-SW: single transplantation
• Sach-SW: stem cell transplantation
• Sach-SW: tandem transplantation
• K10plus-PPN: 1671369564

Abstract

The prospective, randomized phase III trial GMMG-HD2 aimed at demonstrating non-inferiority of single (Arm A) versus tandem (Arm B) high-dose melphalan followed by autologous transplantation (HDM/ASCT) with regard to 2-year event-free survival (EFS) in newly-diagnosed multiple myeloma (MM) and included 358 evaluable patients [Intention-to-treat population, (ITT), single/tandem HDM/ASCT: n = 177/181]. After a median follow-up of more than 11 years, non-inferiority of single versus tandem HDM/ASCT was demonstrated using the planned non-inferiority threshold of 15% of the 2-year EFS rate. Neither EFS (P = 0·53) nor overall survival (OS) (P = 0·33) differences were observed in the ITT population. In the tandem arm, 26% (n = 47/181) of patients refused a second HDM/ASCT due to non-medical reasons. A per-protocol (PP) analysis, including patients who received the intervention (single/tandem HDM/ASCT: n = 156/93) and patients who did not receive a second HDM/ASCT due to medical reasons (12%, n = 22/181), did not yield differences in EFS (P = 0·61) or OS (P = 0·16). In the ITT and PP set of the tandem arm, the rates of complete responses increased from first to second HDM/ASCT (both P = 0·04). Ten-year OS for the entire ITT was 34% (95% confidence interval: 29-40%). OS after first relapse was significantly shortened in the tandem arm (P = 0·04). In this study single HDM/ASCT was non-inferior to tandem HDM/ASCT in MM.