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논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2018.1
- 수록면
- 105 - 109 (5page)
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Background High-dose melphalan (HDMEL) represents the standard conditioning regimen before autologous stem cell transplant (ASCT) in multiple myeloma (MM), but recent updates have suggested combination of melphalan with bulsulfan (BUMEL) is also associated with favorable outcomes. We performed the current study to address the lack of comparative studies between the two conditioning regimens in Asian populations. Methods Using the Korean National Health Insurance and Korean Health Insurance Review and Assessment Service databases, 1,304 patients newly diagnosed with MM undergoing ASCT between January 2010 and December 2014 were identified. Patients were divided according to conditioning regimen (HDMEL vs. BUMEL), and after case matching, 428 patients undergoing HDMEL conditioning were compared to 107 patients undergoing BUMEL conditioning with respect to clinical course and treatment outcomes. Results The 3-year progression-free survival (PFS) was 52.5% for the HDMEL conditioning group versus 70.3% for the BUMEL conditioning group (P=0.043). The 3-year overall survival (OS) was 82.0% versus 83.5% (P=0.525), respectively. Although not statistically significant, BUMEL conditioning was associated with more platelet transfusion, while HDMEL was associated with more granulocyte colony stimulating factor support. In multivariate analysis, BUMEL conditioning was not inferior to HDMEL conditioning in regard to both PFS and OS. Conclusion Our study confirmed that BUMEL is an effective and well-tolerated alternative to HDMEL conditioning, with better PFS.
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참고문헌 (23)
참고문헌 신청
Djulbegovic B / 2008 / Multiple myeloma: detecting the effects of new treatments / Lancet 371:1642~1644
Rajkumar SV / 2016 / Multiple myeloma: 2016 update on diagnosis, risk-stratification, and management / Am J Hematol 91:719~734
Maybury B / 2016 / Augmenting autologous stem cell transplantation to improve outcomes in myeloma / Biol Blood Marrow Transplant 22:1926~1937
Raza S / 2017 / Optimizing current and emerging therapies in multiple myeloma: a guide for the hematologist / Ther Adv Hematol 8:55~70
Reece D / 2013 / Efficacy and safety of busulfan-based conditioning regimens for multiple myeloma / Oncologist 18:611~618
Rajkumar SV / 2016 / Multiple myeloma: 2016 update on diagnosis, risk-stratification, and management / Am J Hematol 91:719~734
Maybury B / 2016 / Augmenting autologous stem cell transplantation to improve outcomes in myeloma / Biol Blood Marrow Transplant 22:1926~1937
Raza S / 2017 / Optimizing current and emerging therapies in multiple myeloma: a guide for the hematologist / Ther Adv Hematol 8:55~70
Reece D / 2013 / Efficacy and safety of busulfan-based conditioning regimens for multiple myeloma / Oncologist 18:611~618
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