A Prospective, Randomized Trial of Autologous Bone Marrow Transplantation and Chemotherapy in Multiple Myeloma
Open accessAbstract
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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ASCT improves median overall survival in multiple myeloma by about 12 months.
“ASCT improves median OS in multiple myeloma by approximately 12 months.125–128”
From Multiple myeloma: 2024 update on diagnosis, risk-stratification, and management (2024) · cites this paper as [125]
The Event-free and Overall Survival section reports significantly longer overall survival with high-dose therapy and transplantation than with conventional chemotherapy. It gives a median overall survival of 37.4 months for the chemotherapy group, but says the transplant group's median had not yet been reached; it therefore does not establish an approximately 12-month gain in median overall survival. Page numbers are not available in our copy. (LLM, conf=0.90)
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- Authors
- Attal, M., Harousseau, J.-L., Stoppa, A.-M., Sotto, J.-J., Fuzibet, J.-G., Rossi, J.-F., Casassus, P., Maisonneuve, H., Facon, T., Ifrah, N., Payen, C., & Bataille, R.
- Affiliations
- Hôpital Purpan (FR)
- Institut Paoli-Calmettes (FR)
- Hôpital Albert Michallon (FR)
- Centre Hospitalier Universitaire de Nice (FR)
- Hôpital Lapeyronie (FR)
- Hôpital Avicenne (FR)
- Hôpital Claude Huriez (FR)
- Centre Hospitalier Universitaire d'Angers (FR)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1996-07-11
- Volume
- 335
- Issue
- 2
- Pages
- 91-97
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2333363976
- Semantic Scholar
- 923c8b51885adc358366315c9308f7abd6b9fbfd
- Cited by
- 2,548
- References
- 32
- Citations by year
- 2026: 23 · 2025: 31 · 2024: 40 · 2023: 47 · 2022: 54 · 2021: 71 · 2020: 90 · 2019: 56 · 2018: 71 · 2017: 90 · 2016: 81 · 2015: 78 · 2014: 80 · 2013: 104 · 2012: 98
- FWCI
- 31.57
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Hematology › Multiple Myeloma Research and Treatments
- Health Sciences › Medicine › Hematology › Hematopoietic Stem Cell Transplantation
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Amyloidosis: Diagnosis, Treatment, Outcomes
- Keywords
- multiple myeloma, autologous bone marrow transplantation, high-dose chemotherapy, cytotoxic chemotherapy, event-free survival, overall survival, treatment response, treatment-naive patients
- MeSH terms
- Adult, Antineoplastic Combined Chemotherapy Protocols, Carmustine, Combined Modality Therapy, Cyclophosphamide, Doxorubicin, Female, Humans, Male, Melphalan, Middle Aged, Multiple Myeloma, Prednisone, Prospective Studies, Vincristine, Multivariate Analysis, Survival Analysis, Bone Marrow Transplantation, Salvage Therapy, Disease-Free Survival
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