Major Tumor Shrinking and Persistent Molecular Remissions After Consolidation With Bortezomib, Thalidomide, and Dexamethasone in Patients With Autografted Myeloma
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- Marco Ladetto
- From the Department of Experimental Medicine and Oncology, Division of Hematology, University of Torino, S. Giovanni Battista Hospital; Division of Nuclear Medicine, University of Torino, S. Giovanni Battista Hospital, Torino; Department of Hematology, Spedali Civili, Brescia; Hematology and Bone Marrow Transplantation Unit, San Camillo-Forlanini Hospital; Department of Hematology, S. Eugenio Hospital, Tor Vergata University; Department of Hematology, Regina Elena National Cancer Institute, Roma;...
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- Gloria Pagliano
- From the Department of Experimental Medicine and Oncology, Division of Hematology, University of Torino, S. Giovanni Battista Hospital; Division of Nuclear Medicine, University of Torino, S. Giovanni Battista Hospital, Torino; Department of Hematology, Spedali Civili, Brescia; Hematology and Bone Marrow Transplantation Unit, San Camillo-Forlanini Hospital; Department of Hematology, S. Eugenio Hospital, Tor Vergata University; Department of Hematology, Regina Elena National Cancer Institute, Roma;...
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- Simone Ferrero
- From the Department of Experimental Medicine and Oncology, Division of Hematology, University of Torino, S. Giovanni Battista Hospital; Division of Nuclear Medicine, University of Torino, S. Giovanni Battista Hospital, Torino; Department of Hematology, Spedali Civili, Brescia; Hematology and Bone Marrow Transplantation Unit, San Camillo-Forlanini Hospital; Department of Hematology, S. Eugenio Hospital, Tor Vergata University; Department of Hematology, Regina Elena National Cancer Institute, Roma;...
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- Federica Cavallo
- From the Department of Experimental Medicine and Oncology, Division of Hematology, University of Torino, S. Giovanni Battista Hospital; Division of Nuclear Medicine, University of Torino, S. Giovanni Battista Hospital, Torino; Department of Hematology, Spedali Civili, Brescia; Hematology and Bone Marrow Transplantation Unit, San Camillo-Forlanini Hospital; Department of Hematology, S. Eugenio Hospital, Tor Vergata University; Department of Hematology, Regina Elena National Cancer Institute, Roma;...
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- Daniela Drandi
- From the Department of Experimental Medicine and Oncology, Division of Hematology, University of Torino, S. Giovanni Battista Hospital; Division of Nuclear Medicine, University of Torino, S. Giovanni Battista Hospital, Torino; Department of Hematology, Spedali Civili, Brescia; Hematology and Bone Marrow Transplantation Unit, San Camillo-Forlanini Hospital; Department of Hematology, S. Eugenio Hospital, Tor Vergata University; Department of Hematology, Regina Elena National Cancer Institute, Roma;...
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- Loredana Santo
- From the Department of Experimental Medicine and Oncology, Division of Hematology, University of Torino, S. Giovanni Battista Hospital; Division of Nuclear Medicine, University of Torino, S. Giovanni Battista Hospital, Torino; Department of Hematology, Spedali Civili, Brescia; Hematology and Bone Marrow Transplantation Unit, San Camillo-Forlanini Hospital; Department of Hematology, S. Eugenio Hospital, Tor Vergata University; Department of Hematology, Regina Elena National Cancer Institute, Roma;...
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- Claudia Crippa
- From the Department of Experimental Medicine and Oncology, Division of Hematology, University of Torino, S. Giovanni Battista Hospital; Division of Nuclear Medicine, University of Torino, S. Giovanni Battista Hospital, Torino; Department of Hematology, Spedali Civili, Brescia; Hematology and Bone Marrow Transplantation Unit, San Camillo-Forlanini Hospital; Department of Hematology, S. Eugenio Hospital, Tor Vergata University; Department of Hematology, Regina Elena National Cancer Institute, Roma;...
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- Luca De Rosa
- From the Department of Experimental Medicine and Oncology, Division of Hematology, University of Torino, S. Giovanni Battista Hospital; Division of Nuclear Medicine, University of Torino, S. Giovanni Battista Hospital, Torino; Department of Hematology, Spedali Civili, Brescia; Hematology and Bone Marrow Transplantation Unit, San Camillo-Forlanini Hospital; Department of Hematology, S. Eugenio Hospital, Tor Vergata University; Department of Hematology, Regina Elena National Cancer Institute, Roma;...
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- Patrizia Pregno
- From the Department of Experimental Medicine and Oncology, Division of Hematology, University of Torino, S. Giovanni Battista Hospital; Division of Nuclear Medicine, University of Torino, S. Giovanni Battista Hospital, Torino; Department of Hematology, Spedali Civili, Brescia; Hematology and Bone Marrow Transplantation Unit, San Camillo-Forlanini Hospital; Department of Hematology, S. Eugenio Hospital, Tor Vergata University; Department of Hematology, Regina Elena National Cancer Institute, Roma;...
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- Mariella Grasso
- From the Department of Experimental Medicine and Oncology, Division of Hematology, University of Torino, S. Giovanni Battista Hospital; Division of Nuclear Medicine, University of Torino, S. Giovanni Battista Hospital, Torino; Department of Hematology, Spedali Civili, Brescia; Hematology and Bone Marrow Transplantation Unit, San Camillo-Forlanini Hospital; Department of Hematology, S. Eugenio Hospital, Tor Vergata University; Department of Hematology, Regina Elena National Cancer Institute, Roma;...
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- Anna Marina Liberati
- From the Department of Experimental Medicine and Oncology, Division of Hematology, University of Torino, S. Giovanni Battista Hospital; Division of Nuclear Medicine, University of Torino, S. Giovanni Battista Hospital, Torino; Department of Hematology, Spedali Civili, Brescia; Hematology and Bone Marrow Transplantation Unit, San Camillo-Forlanini Hospital; Department of Hematology, S. Eugenio Hospital, Tor Vergata University; Department of Hematology, Regina Elena National Cancer Institute, Roma;...
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- Tommaso Caravita
- From the Department of Experimental Medicine and Oncology, Division of Hematology, University of Torino, S. Giovanni Battista Hospital; Division of Nuclear Medicine, University of Torino, S. Giovanni Battista Hospital, Torino; Department of Hematology, Spedali Civili, Brescia; Hematology and Bone Marrow Transplantation Unit, San Camillo-Forlanini Hospital; Department of Hematology, S. Eugenio Hospital, Tor Vergata University; Department of Hematology, Regina Elena National Cancer Institute, Roma;...
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- Francesco Pisani
- From the Department of Experimental Medicine and Oncology, Division of Hematology, University of Torino, S. Giovanni Battista Hospital; Division of Nuclear Medicine, University of Torino, S. Giovanni Battista Hospital, Torino; Department of Hematology, Spedali Civili, Brescia; Hematology and Bone Marrow Transplantation Unit, San Camillo-Forlanini Hospital; Department of Hematology, S. Eugenio Hospital, Tor Vergata University; Department of Hematology, Regina Elena National Cancer Institute, Roma;...
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- Tommasina Guglielmelli
- From the Department of Experimental Medicine and Oncology, Division of Hematology, University of Torino, S. Giovanni Battista Hospital; Division of Nuclear Medicine, University of Torino, S. Giovanni Battista Hospital, Torino; Department of Hematology, Spedali Civili, Brescia; Hematology and Bone Marrow Transplantation Unit, San Camillo-Forlanini Hospital; Department of Hematology, S. Eugenio Hospital, Tor Vergata University; Department of Hematology, Regina Elena National Cancer Institute, Roma;...
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- Vincenzo Callea
- From the Department of Experimental Medicine and Oncology, Division of Hematology, University of Torino, S. Giovanni Battista Hospital; Division of Nuclear Medicine, University of Torino, S. Giovanni Battista Hospital, Torino; Department of Hematology, Spedali Civili, Brescia; Hematology and Bone Marrow Transplantation Unit, San Camillo-Forlanini Hospital; Department of Hematology, S. Eugenio Hospital, Tor Vergata University; Department of Hematology, Regina Elena National Cancer Institute, Roma;...
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- Pellegrino Musto
- From the Department of Experimental Medicine and Oncology, Division of Hematology, University of Torino, S. Giovanni Battista Hospital; Division of Nuclear Medicine, University of Torino, S. Giovanni Battista Hospital, Torino; Department of Hematology, Spedali Civili, Brescia; Hematology and Bone Marrow Transplantation Unit, San Camillo-Forlanini Hospital; Department of Hematology, S. Eugenio Hospital, Tor Vergata University; Department of Hematology, Regina Elena National Cancer Institute, Roma;...
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- Clotilde Cangialosi
- From the Department of Experimental Medicine and Oncology, Division of Hematology, University of Torino, S. Giovanni Battista Hospital; Division of Nuclear Medicine, University of Torino, S. Giovanni Battista Hospital, Torino; Department of Hematology, Spedali Civili, Brescia; Hematology and Bone Marrow Transplantation Unit, San Camillo-Forlanini Hospital; Department of Hematology, S. Eugenio Hospital, Tor Vergata University; Department of Hematology, Regina Elena National Cancer Institute, Roma;...
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- Roberto Passera
- From the Department of Experimental Medicine and Oncology, Division of Hematology, University of Torino, S. Giovanni Battista Hospital; Division of Nuclear Medicine, University of Torino, S. Giovanni Battista Hospital, Torino; Department of Hematology, Spedali Civili, Brescia; Hematology and Bone Marrow Transplantation Unit, San Camillo-Forlanini Hospital; Department of Hematology, S. Eugenio Hospital, Tor Vergata University; Department of Hematology, Regina Elena National Cancer Institute, Roma;...
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- Mario Boccadoro
- From the Department of Experimental Medicine and Oncology, Division of Hematology, University of Torino, S. Giovanni Battista Hospital; Division of Nuclear Medicine, University of Torino, S. Giovanni Battista Hospital, Torino; Department of Hematology, Spedali Civili, Brescia; Hematology and Bone Marrow Transplantation Unit, San Camillo-Forlanini Hospital; Department of Hematology, S. Eugenio Hospital, Tor Vergata University; Department of Hematology, Regina Elena National Cancer Institute, Roma;...
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- Antonio Palumbo
- From the Department of Experimental Medicine and Oncology, Division of Hematology, University of Torino, S. Giovanni Battista Hospital; Division of Nuclear Medicine, University of Torino, S. Giovanni Battista Hospital, Torino; Department of Hematology, Spedali Civili, Brescia; Hematology and Bone Marrow Transplantation Unit, San Camillo-Forlanini Hospital; Department of Hematology, S. Eugenio Hospital, Tor Vergata University; Department of Hematology, Regina Elena National Cancer Institute, Roma;...
説明
<jats:sec><jats:title>Purpose</jats:title><jats:p> We investigated the effect on minimal residual disease, by qualitative and real-time quantitative polymerase chain reaction (RQ-PCR), of a consolidation regimen that included bortezomib, thalidomide, and dexamethasone (VTD) in patients with multiple myeloma (MM) responding to autologous stem-cell transplantation (auto-SCT). </jats:p></jats:sec><jats:sec><jats:title>Patients and Methods</jats:title><jats:p> Patients achieving at least very good partial response who had an available molecular marker based on the immunoglobulin heavy-chain rearrangement received four courses of treatment every month: four infusions per month of bortezomib at 1.6 mg/m<jats:sup>2</jats:sup>, thalidomide at 200 mg/d, and dexamethasone at 20 mg/d on days 1 to 4, 8 to 11, and 15 to 18. Patients were studied with tumor-clone–specific primers by qualitative nested PCR and RQ-PCR. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> Of 39 patients enrolled, 31 received the four VTD courses. Immunofixation complete responses increased from 15% after auto-SCT to 49% after VTD. Molecular remissions (MRs) were 3% after auto-SCT and 18% after VTD. Median time to maximum response was 3.5 months. So far, no patient in MR has relapsed (median follow-up, 42 months). VTD consolidation induced an additional depletion of 4.14 natural logarithms of tumor burden by RQ-PCR. Patients with a tumor load less than the median value after VTD had outcomes better than those who had tumor loads above the median value after VTD (at median follow-up: progression-free survival, 100% v 57%; P < .001). </jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p> To the best of our knowledge, this study is the first to document the occurrence of persistent MRs in a proportion of MM patients treated without allogeneic transplantation. Moreover, the major reduction in tumor load recorded by RQ-PCR after VTD suggests that unprecedented levels of tumor cell reduction can be achieved in MM thanks to the new nonchemotherapeutic drugs. </jats:p></jats:sec>
収録刊行物
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- Journal of Clinical Oncology
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Journal of Clinical Oncology 28 (12), 2077-2084, 2010-04-20
American Society of Clinical Oncology (ASCO)