Produção Nacional
Revisado por pares
Thalidomide plus dexamethasone as a maintenance therapy after autologous hematopoietic stem cell transplantation improves progression‐free survival in multiple myeloma
2012; Wiley; Volume: 87; Issue: 10 Linguagem: Inglês
10.1002/ajh.23274
ISSN1096-8652
AutoresÂngelo Maiolino, Vânia Hungria, Márcia Garnica, Gislaine Borba Oliveira-Duarte, Luciana Correa Oliveira de Oliveira, Daniel Mercante, Eliana Miranda, Adriana Alvares Quero, Ana Lucia Peres, José Carlos Barros, Paola Tanaka, Roberto Pereira de Magalhães, Eduardo Magalhães Rego, Irene Lorand‐Metze, Carmen Sílvia Passos Lima, Ilana Zalcberg Renault, Esteban Braggio, Carlos Chiattone, Márcio Nucci, Cármino Antônio De Souza,
Tópico(s)Protein Degradation and Inhibitors
ResumoDespite the good response of stem cell transplant (SCT) in the treatment of multiple myeloma (MM), most patients relapse or do not achieve complete remission, suggesting that additional treatment is needed. We assessed the impact of thalidomide in maintenance after SCT in untreated patients with MM. A hundred and eight patients (<70 years old) were randomized to receive maintenance with dexamethasone (arm A; n = 52) or dexamethasone with thalidomide (arm B; n = 56; 200 mg daily) for 12 months or until disease progression. After a median follow-up of 27 months, an intention to treat analysis showed a 2-year progression-free survival (PFS) of 30% in arm A (95% CI 22-38) and 64% in arm B (95% CI 57-71; P = 0.002), with median PFS of 19 months and 36 months, respectively. In patients who did not achieve at least a very good partial response, the PFS at 2 years was significantly higher when in use of thalidomide (19 vs. 59%; P = 0.002). Overall survival at 2 years was not significantly improved (70 vs. 85% in arm A and arm B, respectively; P = 0.27). The addition of thalidomide to dexamethasone as maintenance improved the PFS mainly in patients who did not respond to treatment after SCT.
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