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Titolo:
The implication of compromised renal function at presentation in myeloma -Similar outcome in Patients who receive high-dose therapy: A single-centerstudy of 251 previously untreated patients
Autore:
Sirohi, B; Powles, R; Mehta, J; Treleaven, J; Raje, N; Kulkarni, S; Rudin, C; Bhagwati, N; Horton, C; Saso, R; Singhal, S; Parikh, P;
Indirizzi:
Royal Marsden NHS Trust, Leukaemia Unit, Sutton SM2 5PT, Surrey, England Royal Marsden NHS Trust Sutton Surrey England SM2 5PT PT, Surrey, England
Titolo Testata:
MEDICAL ONCOLOGY
fascicolo: 1, volume: 18, anno: 2001,
pagine: 39 - 50
SICI:
1357-0560(2001)18:1<39:TIOCRF>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
STEM-CELL TRANSPLANTATION; LONG-TERM SURVIVAL; MULTIPLE-MYELOMA; INTENSIVE TREATMENT; AUTOLOGOUS TRANSPLANTATION; METHYLPREDNISOLONE VAMP; COMPLETE REMISSION; RANDOMIZED TRIAL; STAGING SYSTEM; FAILURE;
Keywords:
myeloma; renal function; outcome; sequential therapy;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
41
Recensione:
Indirizzi per estratti:
Indirizzo: Powles, R Royal Marsden NHS Trust, Leukaemia Unit, Downs Rd, Sutton SM2 5PT, Surrey,England Royal Marsden NHS Trust Downs Rd Sutton Surrey England SM2 5PT d
Citazione:
B. Sirohi et al., "The implication of compromised renal function at presentation in myeloma -Similar outcome in Patients who receive high-dose therapy: A single-centerstudy of 251 previously untreated patients", MED ONCOL, 18(1), 2001, pp. 39-50

Abstract

The purpose of the study was to determine the role of sequential therapy (ST) in new patients with myeloma presenting with renal dysfunction (RD): serum creatinine >140 mu mol/L (1.6 mg/dL). Between April 1985 and June 1998,251 patients, 59 (23%) with RD were entered into a ST program comprised ofinfusional chemotherapy (IC) with VAMP/C-VAMP (vincristine, doxorubicin, and methylprednisolone with/without cyclophosphamide) followed by autologoustransplantation and interferon maintenance. The median overall survival (OS) of 251 patients from the start of IC was 4.2 yr with the RD group faring significantly poorer (median 2.5 yr) than those with no renal dysfunction (NRD; median 4.6 yr; p=0.0025). Mortality during the first 100 d of IC was significantly higher in patients with RD (11/59; p=0.01) compared to patients with NRD. In patients consolidated with high-dose therapy, the OS and event-free survival (EFS) were not significantly different between the two groups. Cox analysis of the variables at presentation failed to show RD as a factor influencing outcome, but it showed that patients with beta-2-microglobulin (beta M-2) greater than or equal to3.7 (p<0.0001), age <greater than or equal to> yr (p=0.002), performance status (PS) greater than or equal to2 (p=0.005) and patients with light-chain myeloma (p=0.03) had a significantly shorter OS, beta M-2 greater than or equal to 3.7, PS greater than or equal to 2, and light-chain myeloma were predictive of shorter EFS. The study shows that with modern intensive schedules of treatment, renal disease at presentation in isolation does not compromise outcome.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/01/20 alle ore 16:32:47