The Hematology DSG noted that the use of transplantation for patients with myeloma varied among practice s across the province .
In terms of survival , is  peripheral blood stem-cell  or  marrow transplantation better than conventional chemotherapy ?
What is the relative efficacy of autologous versus allogeneic transplantation ?
What specifics of the transplantation process can be recommended ?
The addition of interferon is unlikely to influence outcomes in the control group .
In Terms of Survival , Is Autologous Peripheral Blood Stem-Cell or Bone Marrow Transplantation Better than Conventional Chemotherapy ?
After more than three decades of clinical trials testing various st and ard-dose chemotherapy regimens , the disease course of patients with multiple myeloma has not changed appreciably .
Conventional chemotherapy can provide effective palliation but is not curative ( 1 ) .
Case series have described encouraging results in patients with myeloma undergoing allogeneic or autologous bone marrow or peripheral blood stem-cell transplantation ( 2 ) .
Other studies of transplantation , including r and omized trials , have been reported in the past 6 years ( 3 , 4 ) .
To facilitate decisions about treatment options , practice guidelines have been developed for use by health care providers and consumers .
In Ontario , Canada , cancer treatments and policies are led by a state-funded organization , Cancer Care Ontario .
To help derive treatment options , Cancer Care Ontario has developed the Program in Evidence -Based Care , which includes the Practice Guidelines Initiative .
To approach this topic , the DSG addressed the following questions : What is optimal st and ard-dose chemotherapy for patients with myeloma ?
When should transplantation be performed ?
Who should ( or should not ) receive a transplant ?
Impact on survival of high-dose therapy with autologous stem cell support in patients younger than 60 years with newly diagnosed multiple myeloma: a population-based study. Nordic Myeloma Study Group.
High-dose therapy has become a common treatment for myeloma . The objectives of this study were to estimate in a prospect i ve , population -based setting the impact on survival of high-dose therapy in newly diagnosed , symptomatic patients less than 60 years old and to compare the results with those of conventionally treated historic controls . The prospect i ve population comprised 348 patients . Of these , 274 were treated according to a specified intensive-therapy protocol ( Nordic Myeloma Study Group [ NMSG ] # 5/94 ) and constituted the intensive-therapy group . The historic population consisted of 313 patients identified from 5 previous population -based Nordic studies . Of these , 274 fulfilled the eligibility criteria for high-dose therapy stated in NMSG # 5/94 and constituted the control group . The expected numbers of patients in the prospect i ve population and the historic population were 450 and 410 , respectively , estimated from previously established data on the incidence in this population and the population base for each study . Survival was prolonged in the intensive-therapy group compared with the control group ( risk ratio for the control group 1.62 ; 95 % confidence interval 1.22 - 2.15 ; P = .001 ) . These groups represented more than 60 % of the expected number of patients . When survival for all the registered patients in the 2 population s was compared , representing more than 75 % of the expected number of patients , the advantage for the prospect i ve population persisted ( risk ratio for the historic population 1.46 ; 95 % confidence interval 1.14 - 1.86 ; P = . 002 ) . These results indicate that the introduction of high-dose therapy for newly diagnosed myeloma has result ed in prolonged survival for the total patient population aged less than 60 years . ( Blood . 2000 ; 95:7 - 11
The Hematology DSG noted that the use of transplantation for patients with myeloma varied among practice s across the province .
In terms of survival , is  peripheral blood stem-cell  or  marrow transplantation better than conventional chemotherapy ?
What is the relative efficacy of autologous versus allogeneic transplantation ?
What specifics of the transplantation process can be recommended ?
The addition of interferon is unlikely to influence outcomes in the control group .
In Terms of Survival , Is Autologous Peripheral Blood Stem-Cell or Bone Marrow Transplantation Better than Conventional Chemotherapy ?
After more than three decades of clinical trials testing various st and ard-dose chemotherapy regimens , the disease course of patients with multiple myeloma has not changed appreciably .
Conventional chemotherapy can provide effective palliation but is not curative ( 1 ) .
Case series have described encouraging results in patients with myeloma undergoing allogeneic or autologous bone marrow or peripheral blood stem-cell transplantation ( 2 ) .
Other studies of transplantation , including r and omized trials , have been reported in the past 6 years ( 3 , 4 ) .
To facilitate decisions about treatment options , practice guidelines have been developed for use by health care providers and consumers .
In Ontario , Canada , cancer treatments and policies are led by a state-funded organization , Cancer Care Ontario .
To help derive treatment options , Cancer Care Ontario has developed the Program in Evidence -Based Care , which includes the Practice Guidelines Initiative .
To approach this topic , the DSG addressed the following questions : What is optimal st and ard-dose chemotherapy for patients with myeloma ?
When should transplantation be performed ?
Who should ( or should not ) receive a transplant ?