As lead author of a study by the Eastern Cooperative Oncology Group (ECOG), David S. Siegel, M.D., Ph.D., Co-Chief of Multiple Myeloma at the John Theurer Center, retrospectively analyzed data from the ECOG E4A03 trial. The earlier trial tested combination therapies for newly diagnosed multiple myeloma patients.
"We wanted to look at the effect of early autologous peripheral blood stem cell transplantation," said Dr. Siegel. "Transplantation in early-stage myeloma has become controversial because combination therapies with lenalidomide and dexamethasone have been shown to dramatically improve outcomes."
This transplantation technique, which uses a patient's own adult stem cells, has been a first-line treatment for patients who are newly diagnosed with this blood cancer. Multiple myeloma is a cancer that attacks plasma cells, which protect the body against disease and infection. It currently has a very poor prognosis.
Patients in the study were randomized to receive either lenalidomide with high-dose dexamethasone or lenalidomide with low-dose dexamethasone. After four rounds of treatment, patients had the option of continuing with drug therapy or receiving a stem cell transplant. For patients under the age of 65 who survived four cycles of treatment, overall survival at three years was 94 percent with early stem cell transplantation, vs. 78 percent for those who continued to receive a drug regimen instead.
"This analysis shows that the strategy of combining these medications followed by early adult stem cell transplantation has a remarkably good outcome and supports the continued role of early transplantation in the newly diagnosed," said Dr. Siegel. "Additional randomized trials on the timing of ASCT in myeloma may provide more answers on optimal treatment strategies."
This research was presented at the annual meeting of the American Society of Hematology (ASH) taking place December 4-7, 2010 in Orlando, Florida.
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