BACKGROUND AND OBJECTIVE: The outcome of @entity1 with @entity1582 ( @entity1582 ) has not changed markedly since the introduction of melphalan and @entity229 . In recent years several studies have investigated the role of intensive therapy followed by infusion of autologous peripheral blood stem cells (PBSC) together with the administration of hematopoietic growth factors. In this study we evaluated the feasibility and efficacy of a PBSC transplantation program for @entity1 with de novo @entity1582 in a multicenter setting. DESIGN AND METHODS: In a non-randomized controlled trial 52 @entity1 with de novo @entity1582 from 6 Italian centers underwent a three phase treatment strategy including 3 cycles of VAD-like chemotherapy for initial debulking, followed by high-dose @entity786 (HD-CY) and collection of PBSC, that were transplanted after a conditioning regimen with melphalan plus @entity1863 . Maintenance treatment was a conventional dose of interferon, given until relapse. Actuarial survival and response duration curves were plotted according to Kaplan and Meier's method; the groups were compared using the log rank test. Response rates were compared by the c(2) test; multivariate analysis was performed according to the stepwise regression model. RESULTS: Overall 39/52 (75%) of @entity1 responded, with a complete remission (CR) rate of 31%. After a median follow-up of 55 months, median duration of event-free survival (EFS) and overall survival (OS) are 21 and 57 months, with 24% and 48% probabilities of being event-free and alive after 6 years, respectively. Among the group of 39 responders, CR was significantly associated with prolonged response and survival (2 deaths and 6 relapses/16 @entity1 ) as compared with PR (11 deaths and 15 relapses/23 @entity1 ), and remained the only significant variable also in a multivariate analysis. Myelosuppression did not protract beyond one week in transplanted @entity1 ; extra-hematologic @entity137 was very low. INTERPRETATION AND CONCLUSIONS: This multicenter study confirms the feasibility of an aggressive approach to de novo @entity1582 @entity1 . Additional confirmation is given of the increased rate of CR, and the significant prolonged survival observed in complete responders. In this experience the association melphalan plus @entity1863 was shown to be effective, at least as part of conditioning regimens, in the transplant strategy.

Autologous peripheral blood stem cell transplantation as first line treatment of XXXX : an Italian Multicenter Study.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity137 :: ('MESH:D064420', 'Disease') :: ['toxicity'] @entity229 :: ('MESH:D011241', 'Chemical') :: ['prednisone'] @entity786 :: ('MESH:D003520', 'Chemical') :: ['cyclophosphamide'] @entity1582 :: ('MESH:D009101', 'Disease') :: ['multiple myeloma', 'MM'] @entity1863 :: ('MESH:D002066', 'Chemical') :: ['busulfan']
@entity1582 :: (MESH:D009101,Disease) :: ['multiple myeloma']
