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dc.contributor.authorHunter, H M
dc.contributor.authorPeggs, Karl S
dc.contributor.authorPowles, R
dc.contributor.authorRahemtulla, A
dc.contributor.authorMahendra, Premini
dc.contributor.authorCavenagh, Jamie
dc.contributor.authorLittlewood, Timothy
dc.contributor.authorPotter, M
dc.contributor.authorHunter, Ann
dc.contributor.authorPagliuca, A
dc.contributor.authorWilliams, Catherine D
dc.contributor.authorCook, Gordon
dc.contributor.authorTowlson, Keiren
dc.contributor.authorMarks, David I
dc.contributor.authorRussell, Nigel
dc.date.accessioned2009-07-22T10:36:02Z
dc.date.available2009-07-22T10:36:02Z
dc.date.issued2005-02
dc.identifier.citationAnalysis of outcome following allogeneic haemopoietic stem cell transplantation for myeloma using myeloablative conditioning--evidence for a superior outcome using melphalan combined with total body irradiation. 2005, 128 (4):496-502 Br. J. Haematol.en
dc.identifier.issn0007-1048
dc.identifier.pmid15686458
dc.identifier.doi10.1111/j.1365-2141.2004.05330.x
dc.identifier.urihttp://hdl.handle.net/10541/74925
dc.description.abstractWe have undertaken a retrospective multicentre analysis of 139 patients (median age 44.4 years) undergoing allogeneic haematopoietic stem cell transplantation (HSCT) for multiple myeloma using myeloablative conditioning. The majority of patients received total body irradiation (TBI) combined with either melphalan (56.9%) or cyclophosphamide (28.5%). Overall, transplant-related mortality (TRM) was 37.9% at 1 year and was not significantly different for patients receiving melphalan/TBI compared with cyclophosphamide/TBI. The overall complete remission (CR) rate, including patients in CR at the time of transplant, was greater for patients receiving melphalan/TBI (64.7%) compared with cyclophosphamide/TBI (47.2%)(P = 0.085). A significantly higher proportion of patients with continuing disease at the time of transplant achieved CR post-transplant following melphalan/TBI conditioning compared with cyclophosphamide/TBI (52.9% and 33.4% respectively, P = 0.009). Relapse/progression rates at 5 years were significantly lower for melphalan/TBI (36.7%) compared with cyclophosphamide/TBI (80.8%, P < 0.0001) and remained significant in multivariate analysis. This resulted in an overall survival at 5 years of 44.1% and 28.1% for melphalan/TBI and cyclophosphamide/TBI, respectively (P = 0.059). These results demonstrate that the type of conditioning for sibling allogeneic HSCT for myeloma has a major effect on transplant outcome.
dc.language.isoenen
dc.subjectHaematopoietic Stem Cell Transplantationen
dc.subject.meshAdult
dc.subject.meshAntineoplastic Agents, Alkylating
dc.subject.meshDisease Progression
dc.subject.meshDisease-Free Survival
dc.subject.meshFemale
dc.subject.meshGraft vs Host Disease
dc.subject.meshHematopoietic Stem Cell Transplantation
dc.subject.meshHumans
dc.subject.meshMale
dc.subject.meshMelphalan
dc.subject.meshMiddle Aged
dc.subject.meshMultiple Myeloma
dc.subject.meshRemission Induction
dc.subject.meshRetrospective Studies
dc.subject.meshSurvival Analysis
dc.subject.meshTransplantation Conditioning
dc.subject.meshTreatment Outcome
dc.subject.meshWhole-Body Irradiation
dc.titleAnalysis of outcome following allogeneic haemopoietic stem cell transplantation for myeloma using myeloablative conditioning--evidence for a superior outcome using melphalan combined with total body irradiation.en
dc.typeArticleen
dc.contributor.departmentNottingham City Hospital, Nottingham NG5 1PB, UK.en
dc.identifier.journalBritish Journal of Haematologyen
html.description.abstractWe have undertaken a retrospective multicentre analysis of 139 patients (median age 44.4 years) undergoing allogeneic haematopoietic stem cell transplantation (HSCT) for multiple myeloma using myeloablative conditioning. The majority of patients received total body irradiation (TBI) combined with either melphalan (56.9%) or cyclophosphamide (28.5%). Overall, transplant-related mortality (TRM) was 37.9% at 1 year and was not significantly different for patients receiving melphalan/TBI compared with cyclophosphamide/TBI. The overall complete remission (CR) rate, including patients in CR at the time of transplant, was greater for patients receiving melphalan/TBI (64.7%) compared with cyclophosphamide/TBI (47.2%)(P = 0.085). A significantly higher proportion of patients with continuing disease at the time of transplant achieved CR post-transplant following melphalan/TBI conditioning compared with cyclophosphamide/TBI (52.9% and 33.4% respectively, P = 0.009). Relapse/progression rates at 5 years were significantly lower for melphalan/TBI (36.7%) compared with cyclophosphamide/TBI (80.8%, P < 0.0001) and remained significant in multivariate analysis. This resulted in an overall survival at 5 years of 44.1% and 28.1% for melphalan/TBI and cyclophosphamide/TBI, respectively (P = 0.059). These results demonstrate that the type of conditioning for sibling allogeneic HSCT for myeloma has a major effect on transplant outcome.


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