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High-dose chemotherapy and autologous hematopoietic stem cell transplantation in myeloma patients under the age of 65 years.

Abstract：

:One or two cycles of high-dose chemotherapy with autologous hematopoietic stem cell transplantation have been shown to improve response rates and survival in myeloma. While this observation has largely been made in patients under the age of 65 years, there is evidence to suggest that the conclusions can be extrapolated to older individuals as well. In contrast to other hematologic malignancies treated with high-dose therapy, autografted myeloma patients continue to relapse several years after transplantation, and few patients are cured with this modality. However, up to a third of patients may be alive beyond a decade; some with excellent quality of life giving rise to the concept of 'operational cure'. Relapsing disease can be treated with novel agents or repeat high-dose chemotherapy and transplantation. The pressing questions to which answers are not obvious at the moment are whether tandem transplantation should be offered to all patients, and whether novel agents should be used before transplantation or reserved for relapse. Despite their excellent activity, there is no evidence so far that novel agents such as thalidomide, bortezomib and lenalidomide can replace high-dose chemotherapy and stem cell transplantation.

journal_name

Bone Marrow Transplant

journal_title

Bone marrow transplantation

authors

Mehta J,Singhal S

doi

10.1038/sj.bmt.1705799

subject

Has Abstract

pub_date

2007-12-01 00:00:00

pages

1101-14

issue

12

eissn

0268-3369

issn

1476-5365

pii

1705799

journal_volume

40

pub_type

杂志文章,评审

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