Medline: 8649495

The abstract and fulltext New England Journal of Medicine 335(2): 91-97, 1996. is available online.

A prospective, randomized trial of autologous bone marrow transplantation and chemotherapy in multiple myeloma.

Attal M, Harousseau JL, Stoppa AM, et al.

Abstract:

Background:
The median survival of patients with myeloma after conventional chemotherapy is three years or less. Promising results have been reported with high-dose therapy supported by autologous bone marrow transplantation. We conducted a randomized study comparing conventional chemotherapy and high-dose therapy.

Methods:
Two hundred previously untreated patients under the age of 65 years who had myeloma were randomly assigned at the time of diagnosis to receive either conventional chemotherapy or high-dose therapy and autologous bone marrow transplantation.

Results:
The response rate among the patients who received high-dose therapy was 81 percent (including complete responses in 22 percent and very good partial responses in 16 percent), whereas it was 57 percent (complete responses in 5 percent and very good partial responses in 9 percent) in the group treated with conventional chemotherapy (P < 0.001). The probability of event-free survival for five years was 28 percent in the high-dose group and 10 percent in the conventional-dose group (P = 0.01); the overall estimated rate of survival for five years was 52 percent in the high-dose group and 12 percent in the conventional-dose group (P = 0.03). Treatment-related mortality was similar in the two groups.

Conclusions:
High-dose therapy combined with transplantation improves the response rate, eventfree survival, and overall survival in patients with myeloma.


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