Targeting complete response with upfront bortezomib consolidation versus observation after the achievement of complete response following autologous transplantation for multiple myeloma (TUBA study)
Hideki Nakasone
Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan
Search for more papers by this authorKiriko Terasako-Saito
Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan
Search for more papers by this authorTeiichi Hirano
Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan
Search for more papers by this authorAtsushi Wake
Department of Hematology, Toranomon Hospital Kajigaya, Kawasaki, Japan
Okinaka Memorial Institute of Medical Research, Tokyo, Japan
Search for more papers by this authorSeiichi Shimizu
Department of Hematology, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
Search for more papers by this authorNaoki Kurita
Department of Hematology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
Search for more papers by this authorEtsuko Yamazaki
Department of Hematology and Clinical Immunology, Yokohama City University Hospital, Yokohama, Japan
Clinical Laboratory Department, Yokohama City University Hospital, Yokohama, Japan
Search for more papers by this authorKensuke Usuki
Department of Hematology, NTT Medical Center Tokyo, Tokyo, Japan
Search for more papers by this authorKohei Akazawa
Department of Medical Informatics, Niigata University Medical and Dental Hospital, Niigata, Japan
Search for more papers by this authorJunya Kanda
Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan
Search for more papers by this authorKoichiro Minauchi
Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan
Search for more papers by this authorGo Yamamoto
Department of Hematology, Toranomon Hospital, Tokyo, Japan
Search for more papers by this authorShiori Tanimoto
Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan
Search for more papers by this authorMasaharu Kamoshita
Department of Hematology, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
Search for more papers by this authorYasuhisa Yokoyama
Department of Hematology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
Search for more papers by this authorEtsuo Miyaoka
Department of Mathematics, Faculty of Science Division II, Tokyo University of Science, Tokyo, Japan
Search for more papers by this authorShuichi Ota
Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan
Search for more papers by this authorShinichi Kako
Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan
Search for more papers by this authorKoji Izutsu
Department of Hematology, Toranomon Hospital, Tokyo, Japan
Search for more papers by this authorCorresponding Author
Yoshinobu Kanda
Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan
Correspondence
Yoshinobu Kanda MD/PhD, Division of Hematology, Saitama Medical University, Jichi Medical University, 1-847 Amanuma-cho Omiya-ku, Saitama 330-8503, Japan.
Email: [email protected]
Search for more papers by this authorHideki Nakasone
Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan
Search for more papers by this authorKiriko Terasako-Saito
Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan
Search for more papers by this authorTeiichi Hirano
Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan
Search for more papers by this authorAtsushi Wake
Department of Hematology, Toranomon Hospital Kajigaya, Kawasaki, Japan
Okinaka Memorial Institute of Medical Research, Tokyo, Japan
Search for more papers by this authorSeiichi Shimizu
Department of Hematology, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
Search for more papers by this authorNaoki Kurita
Department of Hematology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
Search for more papers by this authorEtsuko Yamazaki
Department of Hematology and Clinical Immunology, Yokohama City University Hospital, Yokohama, Japan
Clinical Laboratory Department, Yokohama City University Hospital, Yokohama, Japan
Search for more papers by this authorKensuke Usuki
Department of Hematology, NTT Medical Center Tokyo, Tokyo, Japan
Search for more papers by this authorKohei Akazawa
Department of Medical Informatics, Niigata University Medical and Dental Hospital, Niigata, Japan
Search for more papers by this authorJunya Kanda
Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan
Search for more papers by this authorKoichiro Minauchi
Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan
Search for more papers by this authorGo Yamamoto
Department of Hematology, Toranomon Hospital, Tokyo, Japan
Search for more papers by this authorShiori Tanimoto
Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan
Search for more papers by this authorMasaharu Kamoshita
Department of Hematology, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
Search for more papers by this authorYasuhisa Yokoyama
Department of Hematology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
Search for more papers by this authorEtsuo Miyaoka
Department of Mathematics, Faculty of Science Division II, Tokyo University of Science, Tokyo, Japan
Search for more papers by this authorShuichi Ota
Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan
Search for more papers by this authorShinichi Kako
Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan
Search for more papers by this authorKoji Izutsu
Department of Hematology, Toranomon Hospital, Tokyo, Japan
Search for more papers by this authorCorresponding Author
Yoshinobu Kanda
Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan
Correspondence
Yoshinobu Kanda MD/PhD, Division of Hematology, Saitama Medical University, Jichi Medical University, 1-847 Amanuma-cho Omiya-ku, Saitama 330-8503, Japan.
Email: [email protected]
Search for more papers by this authorAbstract
Complete response (CR) after treatment for multiple myeloma is associated with superior progression-free survival (PFS). Multiple myeloma patients were prospectively recruited for induction treatment with bortezomib and dexamethasone (BD) followed by autologous hematopoietic cell transplantation (auto-HCT) between 2010 and 2012. If patients did not achieve CR after auto-HCT, BD consolidation therapy was added to target CR.
After the BD induction phase (n = 46), greater than or equal to CR was achieved in 4 patients (8%). After auto-HCT (n = 34), greater than or equal to CR was achieved in 9 patients (20%) and very good partial response (VGPR) was achieved in 11 (24%). Of the 24 patients who received auto-HCT and whose response was less than CR, 21 received BD consolidation therapy for a median of 4 courses. Finally, the maximum response with or without BD consolidation was greater than or equal to CR in 19 (41%), VGPR in 7 (15%), and PR in 6 (13%). Through BD consolidation, CR was achieved in 8 of 11 patients with post-HCT VGPR and in 2 of 12 patients with post-HCT PR.
In total, 4 year PFS and overall survival were 43 and 80%, respectively. After adjusting for clinical factors, there was no difference in PFS between CR patients after auto-HCT and BD consolidation, while patients with less than or equal to VGPR after consolidation had a significantly lower PFS.
Patients with post-HCT CR showed good PFS, and targeting CR through BD consolidation could improve the CR rate. It would be worthwhile to prospectively compare the efficacy of consolidation only for patients who failed to achieve CR to a universal consolidation strategy.
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