Intensive therapy for multiple myeloma in patients younger than 60 years. Long-term results focusing on the effect of the degree of response on survival and relapse pattern after transplantation

Stig Lenhoff; Martin Hjorth; Ingemar Turesson; Jan Westin; Peter Gimsing; Finn Wisloff; Lucia Ahlberg; Kristina Carlson; Ilse Christiansen; Inger Marie Dahl; Karin Forsberg; Lorentz Brinch; Jens Hammerstrom; Hans E. Johnsen; Lene Meldgaard Knudsen; Olle Linder; Ulf-Henrik Mellqvist; Ingerid Nesthus; Johan Lanng Nielsen

Intensive therapy for multiple myeloma in patients younger than 60 years. Long-term results focusing on the effect of the degree of response on survival and relapse pattern after transplantation

Stig Lenhoff, Martin Hjorth, Ingemar Turesson, Jan Westin, Peter Gimsing, Finn Wisloff, Lucia Ahlberg, Kristina Carlson, Ilse Christiansen, Inger Marie Dahl, Karin Forsberg, Lorentz Brinch, Jens Hammerstrom, Hans E. Johnsen, Lene Meldgaard Knudsen, Olle Linder, Ulf-Henrik Mellqvist, Ingerid Nesthus, Johan Lanng Nielsen

Research output: Contribution to journal › Article › peer-review

Abstract

Background and Objectives. From 1994 to 1997 we conducted a population-based, prospective study on intensive therapy in newly diagnosed symptomatic myeloma patients younger than 60 years, comparing their survival to that of a conventionally treated historic population. Long-term results are presented, including the impact of the degree of response on survival and relapse pattern after transplantation. Design and Methods. The prospective population was formed of 397 patients and the historic population of 313 patients. Both populations were calculated to comprise more than 75% of the expected number of new cases. Results. After a median follow-up of 7 years survival was longer in the prospective population than in the historic one (median 60 versus 39 months; p=0.0002). When comparing only patients eligible for intensive therapy the median survival was 63 versus 44 months (p < 0.0001). Attaining a complete response was associated with prolonged event-free survival but not overall survival. The pattern of relapse after transplantation was heterogeneous but could be divided into four major groups; insidious, classical, plasmacytoma form and transformed disease. The median survival after relapse was 29 months. The relapse pattern and time to relapse predicted outcome. Patients relapsing with an insidious or classical form of disease with skeletal events only, or after a long lasting first response were likely to respond well to conventional salvage therapy. In contrast, relapse with multiple symptoms, transformed disease or a short duration of first response implied bad prognosis. Interpretation and conclusions. The relapse pattern after autologous transplantation is heterogeneous and response to salvage therapy is variable. The degree of response and event-free survival after transplantation are not reliable surrogate markers for survival.

Original language	English
Pages (from-to)	1228-1233
Journal	Haematologica
Volume	91
Issue number	9
Publication status	Published - 2006

Bibliographical note

The information about affiliations in this record was updated in December 2015.
The record was previously connected to the following departments: Hematology/Transplantation (013022014), Department of Clinical Sciences, Malmö (013240000), Stem Cell Center (013022011)

Subject classification (UKÄ)

Hematology
Clinical Medicine

Free keywords

response
survival
myeloma
transplantation
relapse

Access to Document

http://www.haematologica.org/backissues/details.php?id=38396

Cite this

Lenhoff, S., Hjorth, M., Turesson, I., Westin, J., Gimsing, P., Wisloff, F., Ahlberg, L., Carlson, K., Christiansen, I., Dahl, I. M., Forsberg, K., Brinch, L., Hammerstrom, J., Johnsen, H. E., Knudsen, L. M., Linder, O., Mellqvist, U.-H., Nesthus, I., & Nielsen, J. L. (2006). Intensive therapy for multiple myeloma in patients younger than 60 years. Long-term results focusing on the effect of the degree of response on survival and relapse pattern after transplantation. Haematologica, 91(9), 1228-1233. http://www.haematologica.org/backissues/details.php?id=38396

@article{e874bc21aab34f4586e8896d4009e7c5,

title = "Intensive therapy for multiple myeloma in patients younger than 60 years. Long-term results focusing on the effect of the degree of response on survival and relapse pattern after transplantation",

abstract = "Background and Objectives. From 1994 to 1997 we conducted a population-based, prospective study on intensive therapy in newly diagnosed symptomatic myeloma patients younger than 60 years, comparing their survival to that of a conventionally treated historic population. Long-term results are presented, including the impact of the degree of response on survival and relapse pattern after transplantation. Design and Methods. The prospective population was formed of 397 patients and the historic population of 313 patients. Both populations were calculated to comprise more than 75% of the expected number of new cases. Results. After a median follow-up of 7 years survival was longer in the prospective population than in the historic one (median 60 versus 39 months; p=0.0002). When comparing only patients eligible for intensive therapy the median survival was 63 versus 44 months (p < 0.0001). Attaining a complete response was associated with prolonged event-free survival but not overall survival. The pattern of relapse after transplantation was heterogeneous but could be divided into four major groups; insidious, classical, plasmacytoma form and transformed disease. The median survival after relapse was 29 months. The relapse pattern and time to relapse predicted outcome. Patients relapsing with an insidious or classical form of disease with skeletal events only, or after a long lasting first response were likely to respond well to conventional salvage therapy. In contrast, relapse with multiple symptoms, transformed disease or a short duration of first response implied bad prognosis. Interpretation and conclusions. The relapse pattern after autologous transplantation is heterogeneous and response to salvage therapy is variable. The degree of response and event-free survival after transplantation are not reliable surrogate markers for survival.",

keywords = "response, survival, myeloma, transplantation, relapse",

author = "Stig Lenhoff and Martin Hjorth and Ingemar Turesson and Jan Westin and Peter Gimsing and Finn Wisloff and Lucia Ahlberg and Kristina Carlson and Ilse Christiansen and Dahl, {Inger Marie} and Karin Forsberg and Lorentz Brinch and Jens Hammerstrom and Johnsen, {Hans E.} and Knudsen, {Lene Meldgaard} and Olle Linder and Ulf-Henrik Mellqvist and Ingerid Nesthus and Nielsen, {Johan Lanng}",

note = "The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Hematology/Transplantation (013022014), Department of Clinical Sciences, Malm{\"o} (013240000), Stem Cell Center (013022011)",

year = "2006",

language = "English",

volume = "91",

pages = "1228--1233",

journal = "Haematologica",

issn = "1592-8721",

publisher = "Ferrata Storti Foundation",

number = "9",

}

Lenhoff, S, Hjorth, M, Turesson, I, Westin, J, Gimsing, P, Wisloff, F, Ahlberg, L, Carlson, K, Christiansen, I, Dahl, IM, Forsberg, K, Brinch, L, Hammerstrom, J, Johnsen, HE, Knudsen, LM, Linder, O, Mellqvist, U-H, Nesthus, I & Nielsen, JL 2006, 'Intensive therapy for multiple myeloma in patients younger than 60 years. Long-term results focusing on the effect of the degree of response on survival and relapse pattern after transplantation', Haematologica, vol. 91, no. 9, pp. 1228-1233. <http://www.haematologica.org/backissues/details.php?id=38396>

Intensive therapy for multiple myeloma in patients younger than 60 years. Long-term results focusing on the effect of the degree of response on survival and relapse pattern after transplantation. / Lenhoff, Stig; Hjorth, Martin; Turesson, Ingemar et al.
In: Haematologica, Vol. 91, No. 9, 2006, p. 1228-1233.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Intensive therapy for multiple myeloma in patients younger than 60 years. Long-term results focusing on the effect of the degree of response on survival and relapse pattern after transplantation

AU - Lenhoff, Stig

AU - Hjorth, Martin

AU - Turesson, Ingemar

AU - Westin, Jan

AU - Gimsing, Peter

AU - Wisloff, Finn

AU - Ahlberg, Lucia

AU - Carlson, Kristina

AU - Christiansen, Ilse

AU - Dahl, Inger Marie

AU - Forsberg, Karin

AU - Brinch, Lorentz

AU - Hammerstrom, Jens

AU - Johnsen, Hans E.

AU - Knudsen, Lene Meldgaard

AU - Linder, Olle

AU - Mellqvist, Ulf-Henrik

AU - Nesthus, Ingerid

AU - Nielsen, Johan Lanng

N1 - The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Hematology/Transplantation (013022014), Department of Clinical Sciences, Malmö (013240000), Stem Cell Center (013022011)

PY - 2006

Y1 - 2006

N2 - Background and Objectives. From 1994 to 1997 we conducted a population-based, prospective study on intensive therapy in newly diagnosed symptomatic myeloma patients younger than 60 years, comparing their survival to that of a conventionally treated historic population. Long-term results are presented, including the impact of the degree of response on survival and relapse pattern after transplantation. Design and Methods. The prospective population was formed of 397 patients and the historic population of 313 patients. Both populations were calculated to comprise more than 75% of the expected number of new cases. Results. After a median follow-up of 7 years survival was longer in the prospective population than in the historic one (median 60 versus 39 months; p=0.0002). When comparing only patients eligible for intensive therapy the median survival was 63 versus 44 months (p < 0.0001). Attaining a complete response was associated with prolonged event-free survival but not overall survival. The pattern of relapse after transplantation was heterogeneous but could be divided into four major groups; insidious, classical, plasmacytoma form and transformed disease. The median survival after relapse was 29 months. The relapse pattern and time to relapse predicted outcome. Patients relapsing with an insidious or classical form of disease with skeletal events only, or after a long lasting first response were likely to respond well to conventional salvage therapy. In contrast, relapse with multiple symptoms, transformed disease or a short duration of first response implied bad prognosis. Interpretation and conclusions. The relapse pattern after autologous transplantation is heterogeneous and response to salvage therapy is variable. The degree of response and event-free survival after transplantation are not reliable surrogate markers for survival.

AB - Background and Objectives. From 1994 to 1997 we conducted a population-based, prospective study on intensive therapy in newly diagnosed symptomatic myeloma patients younger than 60 years, comparing their survival to that of a conventionally treated historic population. Long-term results are presented, including the impact of the degree of response on survival and relapse pattern after transplantation. Design and Methods. The prospective population was formed of 397 patients and the historic population of 313 patients. Both populations were calculated to comprise more than 75% of the expected number of new cases. Results. After a median follow-up of 7 years survival was longer in the prospective population than in the historic one (median 60 versus 39 months; p=0.0002). When comparing only patients eligible for intensive therapy the median survival was 63 versus 44 months (p < 0.0001). Attaining a complete response was associated with prolonged event-free survival but not overall survival. The pattern of relapse after transplantation was heterogeneous but could be divided into four major groups; insidious, classical, plasmacytoma form and transformed disease. The median survival after relapse was 29 months. The relapse pattern and time to relapse predicted outcome. Patients relapsing with an insidious or classical form of disease with skeletal events only, or after a long lasting first response were likely to respond well to conventional salvage therapy. In contrast, relapse with multiple symptoms, transformed disease or a short duration of first response implied bad prognosis. Interpretation and conclusions. The relapse pattern after autologous transplantation is heterogeneous and response to salvage therapy is variable. The degree of response and event-free survival after transplantation are not reliable surrogate markers for survival.

KW - response

KW - survival

KW - myeloma

KW - transplantation

KW - relapse

M3 - Article

SN - 1592-8721

VL - 91

SP - 1228

EP - 1233

JO - Haematologica

JF - Haematologica

IS - 9

ER -

Intensive therapy for multiple myeloma in patients younger than 60 years. Long-term results focusing on the effect of the degree of response on survival and relapse pattern after transplantation

Abstract

Bibliographical note

Subject classification (UKÄ)

Free keywords

Access to Document

Fingerprint

Cite this