IMWG consensus on maintenance therapy in multiple myeloma
Identifieur interne : 000C95 ( Ncbi/Curation ); précédent : 000C94; suivant : 000C96IMWG consensus on maintenance therapy in multiple myeloma
Auteurs : Heinz Ludwig [Autriche] ; Brian G. M. Durie [États-Unis] ; Philip Mccarthy [États-Unis] ; Antonio Palumbo [Italie] ; Jésus San Miguel [Espagne] ; Bart Barlogie [États-Unis] ; Gareth Morgan [Royaume-Uni] ; Pieter Sonneveld [Pays-Bas] ; Andrew Spencer [Australie] ; Kenneth C. Andersen [États-Unis] ; Thierry Facon [France] ; Keith A. Stewart [États-Unis] ; Hermann Einsele [Allemagne] ; Maria-Victoria Mateos [Espagne] ; Pierre Wijermans [Pays-Bas] ; Anders Waage [Norvège] ; Meral Beksac [Turquie] ; Paul G. Richardson [États-Unis] ; Cyrille Hulin [France] ; Ruben Niesvizky [États-Unis] ; Henk Lokhorst [Pays-Bas] ; Ola Landgren [États-Unis] ; P. Leif Bergsagel [États-Unis] ; Robert Orlowski [États-Unis] ; Axel Hinke [Allemagne] ; Michele Cavo [Italie] ; Michel Attal [France]Source :
- Blood [ 0006-4971 ] ; 2012.
Abstract
Maintaining results of successful induction therapy is an important goal in multiple myeloma. Here, members of the International Myeloma Working Group review the relevant data. Thalidomide maintenance therapy after autologous stem cell transplantation improved the quality of response and increased progression-free survival (PFS) significantly in all 6 studies and overall survival (OS) in 3 of them. In elderly patients, 2 trials showed a significant prolongation of PFS, but no improvement in OS. A meta-analysis revealed a significant risk reduction for PFS/event-free survival and death. The role of thalidomide maintenance after melphalan, prednisone, and thalidomide is not well established. Two trials with lenalidomide maintenance treatment after autologous stem cell transplantation and one study after conventional melphalan, prednisone, and lenalidomide induction therapy showed a significant risk reduction for PFS and an increase in OS in one of the transplant trials. Maintenance therapy with single-agent bortezomib or in combination with thalidomide or prednisone has been studied. One trial revealed a significantly increased OS with a bortezomib-based induction and bortezomib maintenance therapy compared with conventional induction and thalidomide maintenance treatment. Maintenance treatment can be associated with significant side effects, and none of the drugs evaluated is approved for maintenance therapy. Treatment decisions for individual patients must balance potential benefits and risks carefully, as a widely agreed-on standard is not established.
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DOI: 10.1182/blood-2011-11-374249
PubMed: 22271445
PubMed Central: 3321864
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Durie</name><affiliation wicri:level="2"><nlm:aff id="aff2">Southwest Oncology Group, International Myeloma Foundation and Cedars Sinai Comprehensive Cancer Center, Los Angeles, CA;</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Southwest Oncology Group, International Myeloma Foundation and Cedars Sinai Comprehensive Cancer Center, Los Angeles</wicri:cityArea></affiliation></author><author><name sortKey="Mccarthy, Philip" sort="Mccarthy, Philip" uniqKey="Mccarthy P" first="Philip" last="Mccarthy">Philip Mccarthy</name><affiliation wicri:level="2"><nlm:aff id="aff3">Roswell Park Cancer Institute, Buffalo, NY;</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Roswell Park Cancer Institute, Buffalo</wicri:cityArea></affiliation></author><author><name sortKey="Palumbo, Antonio" sort="Palumbo, Antonio" uniqKey="Palumbo A" first="Antonio" last="Palumbo">Antonio Palumbo</name><affiliation wicri:level="3"><nlm:aff id="aff4">Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliera Universitaria S. Giovanni Battista, Torino, Italy;</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliera Universitaria S. 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Andersen</name><affiliation wicri:level="2"><nlm:aff id="aff10">Dana-Farber Cancer Institute, Medical Oncology, Boston, MA;</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Dana-Farber Cancer Institute, Medical Oncology, Boston</wicri:cityArea></affiliation></author><author><name sortKey="Facon, Thierry" sort="Facon, Thierry" uniqKey="Facon T" first="Thierry" last="Facon">Thierry Facon</name><affiliation wicri:level="3"><nlm:aff id="aff11">Department of Hematology, Hospital Claude Huriez, Lille, France;</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of Hematology, Hospital Claude Huriez, Lille</wicri:regionArea><placeName><region type="region">Hauts-de-France</region><region type="old region">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Stewart, Keith A" sort="Stewart, Keith A" uniqKey="Stewart K" first="Keith A." last="Stewart">Keith A. Stewart</name><affiliation wicri:level="2"><nlm:aff id="aff12">Division of Hematology-Oncology, Mayo Clinic, Scottsdale, AZ;</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Arizona</region></placeName><wicri:cityArea>Division of Hematology-Oncology, Mayo Clinic, Scottsdale</wicri:cityArea></affiliation></author><author><name sortKey="Einsele, Hermann" sort="Einsele, Hermann" uniqKey="Einsele H" first="Hermann" last="Einsele">Hermann Einsele</name><affiliation wicri:level="3"><nlm:aff id="aff13">Department of Internal Medicine II, University Hospital, Würzburg, Germany;</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Internal Medicine II, University Hospital, Würzburg</wicri:regionArea><placeName><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Basse-Franconie</region><settlement type="city">Wurtzbourg</settlement></placeName></affiliation></author><author><name sortKey="Mateos, Maria Victoria" sort="Mateos, Maria Victoria" uniqKey="Mateos M" first="Maria-Victoria" last="Mateos">Maria-Victoria Mateos</name><affiliation wicri:level="1"><nlm:aff id="aff5">University Hospital of Salamanca, Salamanca, Spain;</nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea>University Hospital of Salamanca, Salamanca</wicri:regionArea><wicri:noRegion>Salamanca</wicri:noRegion></affiliation></author><author><name sortKey="Wijermans, Pierre" sort="Wijermans, Pierre" uniqKey="Wijermans P" first="Pierre" last="Wijermans">Pierre Wijermans</name><affiliation wicri:level="1"><nlm:aff id="aff14">Haga Hospital, The Hague, The Netherlands;</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Haga Hospital, The Hague</wicri:regionArea><wicri:noRegion>The Hague</wicri:noRegion></affiliation></author><author><name sortKey="Waage, Anders" sort="Waage, Anders" uniqKey="Waage A" first="Anders" last="Waage">Anders Waage</name><affiliation wicri:level="3"><nlm:aff id="aff15">Department of Hematology, St Olavs Hospital, Norwegian University of Science and Technology, Trondheim, Norway;</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Department of Hematology, St Olavs Hospital, Norwegian University of Science and Technology, Trondheim</wicri:regionArea><placeName><settlement type="city">Trondheim</settlement><region type="région" nuts="2">Trøndelag</region></placeName></affiliation></author><author><name sortKey="Beksac, Meral" sort="Beksac, Meral" uniqKey="Beksac M" first="Meral" last="Beksac">Meral Beksac</name><affiliation wicri:level="1"><nlm:aff id="aff16">Department of Microbiology and Clinical Microbiology, Ankara University School of Medicine, Ibn-i Sina Hospital, Ankara, Turkey;</nlm:aff><country xml:lang="fr">Turquie</country><wicri:regionArea>Department of Microbiology and Clinical Microbiology, Ankara University School of Medicine, Ibn-i Sina Hospital, Ankara</wicri:regionArea><wicri:noRegion>Ankara</wicri:noRegion></affiliation></author><author><name sortKey="Richardson, Paul G" sort="Richardson, Paul G" uniqKey="Richardson P" first="Paul G." last="Richardson">Paul G. Richardson</name><affiliation wicri:level="2"><nlm:aff id="aff10">Dana-Farber Cancer Institute, Medical Oncology, Boston, MA;</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Dana-Farber Cancer Institute, Medical Oncology, Boston</wicri:cityArea></affiliation></author><author><name sortKey="Hulin, Cyrille" sort="Hulin, Cyrille" uniqKey="Hulin C" first="Cyrille" last="Hulin">Cyrille Hulin</name><affiliation wicri:level="3"><nlm:aff id="aff17">Hematology Department, University Hospital, Nancy, France;</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Hematology Department, University Hospital, Nancy</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Lorraine (région)</region><settlement type="city">Nancy</settlement></placeName></affiliation></author><author><name sortKey="Niesvizky, Ruben" sort="Niesvizky, Ruben" uniqKey="Niesvizky R" first="Ruben" last="Niesvizky">Ruben Niesvizky</name><affiliation wicri:level="2"><nlm:aff id="aff18">Weill Cornell Medical College, New York, NY;</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Weill Cornell Medical College, New York</wicri:cityArea></affiliation></author><author><name sortKey="Lokhorst, Henk" sort="Lokhorst, Henk" uniqKey="Lokhorst H" first="Henk" last="Lokhorst">Henk Lokhorst</name><affiliation wicri:level="3"><nlm:aff id="aff19">University Medical Center, Utrecht, The Netherlands;</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>University Medical Center, Utrecht</wicri:regionArea><placeName><settlement type="city">Utrecht</settlement><region nuts="2" type="province">Utrecht (province)</region></placeName></affiliation></author><author><name sortKey="Landgren, Ola" sort="Landgren, Ola" uniqKey="Landgren O" first="Ola" last="Landgren">Ola Landgren</name><affiliation wicri:level="2"><nlm:aff id="aff20">Metabolism Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD;</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Maryland</region></placeName><wicri:cityArea>Metabolism Branch, National Cancer Institute, National Institutes of Health, Bethesda</wicri:cityArea></affiliation></author><author><name sortKey="Bergsagel, P Leif" sort="Bergsagel, P Leif" uniqKey="Bergsagel P" first="P. Leif" last="Bergsagel">P. Leif Bergsagel</name><affiliation wicri:level="2"><nlm:aff id="aff12">Division of Hematology-Oncology, Mayo Clinic, Scottsdale, AZ;</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Arizona</region></placeName><wicri:cityArea>Division of Hematology-Oncology, Mayo Clinic, Scottsdale</wicri:cityArea></affiliation></author><author><name sortKey="Orlowski, Robert" sort="Orlowski, Robert" uniqKey="Orlowski R" first="Robert" last="Orlowski">Robert Orlowski</name><affiliation wicri:level="2"><nlm:aff id="aff21">Department of Lymphoma/Myeloma, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, TX;</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Department of Lymphoma/Myeloma, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Hinke, Axel" sort="Hinke, Axel" uniqKey="Hinke A" first="Axel" last="Hinke">Axel Hinke</name><affiliation wicri:level="1"><nlm:aff id="aff22">WISP Research Institute, Langenfeld, Germany;</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>WISP Research Institute, Langenfeld</wicri:regionArea><wicri:noRegion>Langenfeld</wicri:noRegion><wicri:noRegion>Langenfeld</wicri:noRegion><wicri:noRegion>Langenfeld</wicri:noRegion></affiliation></author><author><name sortKey="Cavo, Michele" sort="Cavo, Michele" uniqKey="Cavo M" first="Michele" last="Cavo">Michele Cavo</name><affiliation wicri:level="1"><nlm:aff wicri:cut="; and" id="aff23">Seràgnoli Institute of Haematology, Bologna School of Medicine, S. Orsola's University Hospital, Bologna, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Seràgnoli Institute of Haematology, Bologna School of Medicine, S. Orsola's University Hospital, Bologna</wicri:regionArea><wicri:noRegion>Bologna</wicri:noRegion></affiliation></author><author><name sortKey="Attal, Michel" sort="Attal, Michel" uniqKey="Attal M" first="Michel" last="Attal">Michel Attal</name><affiliation wicri:level="3"><nlm:aff id="aff24">Service d'Hématologie, Hospital Purpan, Toulouse, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Service d'Hématologie, Hospital Purpan, Toulouse</wicri:regionArea><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Midi-Pyrénées</region><settlement type="city">Toulouse</settlement></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">22271445</idno><idno type="pmc">3321864</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3321864</idno><idno type="RBID">PMC:3321864</idno><idno type="doi">10.1182/blood-2011-11-374249</idno><date when="2012">2012</date><idno type="wicri:Area/Pmc/Corpus">002E73</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002E73</idno><idno type="wicri:Area/Pmc/Curation">002D22</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002D22</idno><idno type="wicri:Area/Pmc/Checkpoint">001F03</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">001F03</idno><idno type="wicri:Area/Ncbi/Merge">000C95</idno><idno type="wicri:Area/Ncbi/Curation">000C95</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">IMWG consensus on maintenance therapy in multiple myeloma</title><author><name sortKey="Ludwig, Heinz" sort="Ludwig, Heinz" uniqKey="Ludwig H" first="Heinz" last="Ludwig">Heinz Ludwig</name><affiliation wicri:level="3"><nlm:aff id="aff1">Department of Medicine I, Center for Oncology and Hematology, Wilhelminenspital, Vienna, Austria;</nlm:aff><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Medicine I, Center for Oncology and Hematology, Wilhelminenspital, Vienna</wicri:regionArea><placeName><settlement type="city">Vienne (Autriche)</settlement><region nuts="2" type="province">Vienne (Autriche)</region></placeName></affiliation></author><author><name sortKey="Durie, Brian G M" sort="Durie, Brian G M" uniqKey="Durie B" first="Brian G. M." last="Durie">Brian G. M. Durie</name><affiliation wicri:level="2"><nlm:aff id="aff2">Southwest Oncology Group, International Myeloma Foundation and Cedars Sinai Comprehensive Cancer Center, Los Angeles, CA;</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Southwest Oncology Group, International Myeloma Foundation and Cedars Sinai Comprehensive Cancer Center, Los Angeles</wicri:cityArea></affiliation></author><author><name sortKey="Mccarthy, Philip" sort="Mccarthy, Philip" uniqKey="Mccarthy P" first="Philip" last="Mccarthy">Philip Mccarthy</name><affiliation wicri:level="2"><nlm:aff id="aff3">Roswell Park Cancer Institute, Buffalo, NY;</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Roswell Park Cancer Institute, Buffalo</wicri:cityArea></affiliation></author><author><name sortKey="Palumbo, Antonio" sort="Palumbo, Antonio" uniqKey="Palumbo A" first="Antonio" last="Palumbo">Antonio Palumbo</name><affiliation wicri:level="3"><nlm:aff id="aff4">Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliera Universitaria S. Giovanni Battista, Torino, Italy;</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliera Universitaria S. Giovanni Battista, Torino</wicri:regionArea><placeName><settlement type="city">Turin</settlement><region type="région" nuts="2">Piémont</region></placeName></affiliation></author><author><name sortKey="San Miguel, Jesus" sort="San Miguel, Jesus" uniqKey="San Miguel J" first="Jésus" last="San Miguel">Jésus San Miguel</name><affiliation wicri:level="1"><nlm:aff id="aff5">University Hospital of Salamanca, Salamanca, Spain;</nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea>University Hospital of Salamanca, Salamanca</wicri:regionArea><wicri:noRegion>Salamanca</wicri:noRegion></affiliation></author><author><name sortKey="Barlogie, Bart" sort="Barlogie, Bart" uniqKey="Barlogie B" first="Bart" last="Barlogie">Bart Barlogie</name><affiliation wicri:level="2"><nlm:aff id="aff6">Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR;</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Arkansas</region></placeName><wicri:cityArea>Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock</wicri:cityArea></affiliation></author><author><name sortKey="Morgan, Gareth" sort="Morgan, Gareth" uniqKey="Morgan G" first="Gareth" last="Morgan">Gareth Morgan</name><affiliation wicri:level="3"><nlm:aff id="aff7">Haemato-Oncology Unit, Royal Marsden Hospital, London, United Kingdom;</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Haemato-Oncology Unit, Royal Marsden Hospital, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Sonneveld, Pieter" sort="Sonneveld, Pieter" uniqKey="Sonneveld P" first="Pieter" last="Sonneveld">Pieter Sonneveld</name><affiliation wicri:level="3"><nlm:aff id="aff8">Department of Hematology, Erasmus MC, Rotterdam, The Netherlands;</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Hematology, Erasmus MC, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Spencer, Andrew" sort="Spencer, Andrew" uniqKey="Spencer A" first="Andrew" last="Spencer">Andrew Spencer</name><affiliation wicri:level="1"><nlm:aff id="aff9">Clinical Haematology/Bone Marrow Transplant Department, Alfred Hospital, Melbourne, Victoria, Australia;</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Clinical Haematology/Bone Marrow Transplant Department, Alfred Hospital, Melbourne, Victoria</wicri:regionArea><wicri:noRegion>Victoria</wicri:noRegion></affiliation></author><author><name sortKey="Andersen, Kenneth C" sort="Andersen, Kenneth C" uniqKey="Andersen K" first="Kenneth C." last="Andersen">Kenneth C. Andersen</name><affiliation wicri:level="2"><nlm:aff id="aff10">Dana-Farber Cancer Institute, Medical Oncology, Boston, MA;</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Dana-Farber Cancer Institute, Medical Oncology, Boston</wicri:cityArea></affiliation></author><author><name sortKey="Facon, Thierry" sort="Facon, Thierry" uniqKey="Facon T" first="Thierry" last="Facon">Thierry Facon</name><affiliation wicri:level="3"><nlm:aff id="aff11">Department of Hematology, Hospital Claude Huriez, Lille, France;</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Department of Hematology, Hospital Claude Huriez, Lille</wicri:regionArea><placeName><region type="region">Hauts-de-France</region><region type="old region">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Stewart, Keith A" sort="Stewart, Keith A" uniqKey="Stewart K" first="Keith A." last="Stewart">Keith A. Stewart</name><affiliation wicri:level="2"><nlm:aff id="aff12">Division of Hematology-Oncology, Mayo Clinic, Scottsdale, AZ;</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Arizona</region></placeName><wicri:cityArea>Division of Hematology-Oncology, Mayo Clinic, Scottsdale</wicri:cityArea></affiliation></author><author><name sortKey="Einsele, Hermann" sort="Einsele, Hermann" uniqKey="Einsele H" first="Hermann" last="Einsele">Hermann Einsele</name><affiliation wicri:level="3"><nlm:aff id="aff13">Department of Internal Medicine II, University Hospital, Würzburg, Germany;</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Internal Medicine II, University Hospital, Würzburg</wicri:regionArea><placeName><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Basse-Franconie</region><settlement type="city">Wurtzbourg</settlement></placeName></affiliation></author><author><name sortKey="Mateos, Maria Victoria" sort="Mateos, Maria Victoria" uniqKey="Mateos M" first="Maria-Victoria" last="Mateos">Maria-Victoria Mateos</name><affiliation wicri:level="1"><nlm:aff id="aff5">University Hospital of Salamanca, Salamanca, Spain;</nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea>University Hospital of Salamanca, Salamanca</wicri:regionArea><wicri:noRegion>Salamanca</wicri:noRegion></affiliation></author><author><name sortKey="Wijermans, Pierre" sort="Wijermans, Pierre" uniqKey="Wijermans P" first="Pierre" last="Wijermans">Pierre Wijermans</name><affiliation wicri:level="1"><nlm:aff id="aff14">Haga Hospital, The Hague, The Netherlands;</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Haga Hospital, The Hague</wicri:regionArea><wicri:noRegion>The Hague</wicri:noRegion></affiliation></author><author><name sortKey="Waage, Anders" sort="Waage, Anders" uniqKey="Waage A" first="Anders" last="Waage">Anders Waage</name><affiliation wicri:level="3"><nlm:aff id="aff15">Department of Hematology, St Olavs Hospital, Norwegian University of Science and Technology, Trondheim, Norway;</nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea>Department of Hematology, St Olavs Hospital, Norwegian University of Science and Technology, Trondheim</wicri:regionArea><placeName><settlement type="city">Trondheim</settlement><region type="région" nuts="2">Trøndelag</region></placeName></affiliation></author><author><name sortKey="Beksac, Meral" sort="Beksac, Meral" uniqKey="Beksac M" first="Meral" last="Beksac">Meral Beksac</name><affiliation wicri:level="1"><nlm:aff id="aff16">Department of Microbiology and Clinical Microbiology, Ankara University School of Medicine, Ibn-i Sina Hospital, Ankara, Turkey;</nlm:aff><country xml:lang="fr">Turquie</country><wicri:regionArea>Department of Microbiology and Clinical Microbiology, Ankara University School of Medicine, Ibn-i Sina Hospital, Ankara</wicri:regionArea><wicri:noRegion>Ankara</wicri:noRegion></affiliation></author><author><name sortKey="Richardson, Paul G" sort="Richardson, Paul G" uniqKey="Richardson P" first="Paul G." last="Richardson">Paul G. Richardson</name><affiliation wicri:level="2"><nlm:aff id="aff10">Dana-Farber Cancer Institute, Medical Oncology, Boston, MA;</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Massachusetts</region></placeName><wicri:cityArea>Dana-Farber Cancer Institute, Medical Oncology, Boston</wicri:cityArea></affiliation></author><author><name sortKey="Hulin, Cyrille" sort="Hulin, Cyrille" uniqKey="Hulin C" first="Cyrille" last="Hulin">Cyrille Hulin</name><affiliation wicri:level="3"><nlm:aff id="aff17">Hematology Department, University Hospital, Nancy, France;</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Hematology Department, University Hospital, Nancy</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Lorraine (région)</region><settlement type="city">Nancy</settlement></placeName></affiliation></author><author><name sortKey="Niesvizky, Ruben" sort="Niesvizky, Ruben" uniqKey="Niesvizky R" first="Ruben" last="Niesvizky">Ruben Niesvizky</name><affiliation wicri:level="2"><nlm:aff id="aff18">Weill Cornell Medical College, New York, NY;</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>Weill Cornell Medical College, New York</wicri:cityArea></affiliation></author><author><name sortKey="Lokhorst, Henk" sort="Lokhorst, Henk" uniqKey="Lokhorst H" first="Henk" last="Lokhorst">Henk Lokhorst</name><affiliation wicri:level="3"><nlm:aff id="aff19">University Medical Center, Utrecht, The Netherlands;</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>University Medical Center, Utrecht</wicri:regionArea><placeName><settlement type="city">Utrecht</settlement><region nuts="2" type="province">Utrecht (province)</region></placeName></affiliation></author><author><name sortKey="Landgren, Ola" sort="Landgren, Ola" uniqKey="Landgren O" first="Ola" last="Landgren">Ola Landgren</name><affiliation wicri:level="2"><nlm:aff id="aff20">Metabolism Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD;</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Maryland</region></placeName><wicri:cityArea>Metabolism Branch, National Cancer Institute, National Institutes of Health, Bethesda</wicri:cityArea></affiliation></author><author><name sortKey="Bergsagel, P Leif" sort="Bergsagel, P Leif" uniqKey="Bergsagel P" first="P. Leif" last="Bergsagel">P. Leif Bergsagel</name><affiliation wicri:level="2"><nlm:aff id="aff12">Division of Hematology-Oncology, Mayo Clinic, Scottsdale, AZ;</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Arizona</region></placeName><wicri:cityArea>Division of Hematology-Oncology, Mayo Clinic, Scottsdale</wicri:cityArea></affiliation></author><author><name sortKey="Orlowski, Robert" sort="Orlowski, Robert" uniqKey="Orlowski R" first="Robert" last="Orlowski">Robert Orlowski</name><affiliation wicri:level="2"><nlm:aff id="aff21">Department of Lymphoma/Myeloma, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, TX;</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Department of Lymphoma/Myeloma, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston</wicri:cityArea></affiliation></author><author><name sortKey="Hinke, Axel" sort="Hinke, Axel" uniqKey="Hinke A" first="Axel" last="Hinke">Axel Hinke</name><affiliation wicri:level="1"><nlm:aff id="aff22">WISP Research Institute, Langenfeld, Germany;</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>WISP Research Institute, Langenfeld</wicri:regionArea><wicri:noRegion>Langenfeld</wicri:noRegion><wicri:noRegion>Langenfeld</wicri:noRegion><wicri:noRegion>Langenfeld</wicri:noRegion></affiliation></author><author><name sortKey="Cavo, Michele" sort="Cavo, Michele" uniqKey="Cavo M" first="Michele" last="Cavo">Michele Cavo</name><affiliation wicri:level="1"><nlm:aff wicri:cut="; and" id="aff23">Seràgnoli Institute of Haematology, Bologna School of Medicine, S. Orsola's University Hospital, Bologna, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Seràgnoli Institute of Haematology, Bologna School of Medicine, S. Orsola's University Hospital, Bologna</wicri:regionArea><wicri:noRegion>Bologna</wicri:noRegion></affiliation></author><author><name sortKey="Attal, Michel" sort="Attal, Michel" uniqKey="Attal M" first="Michel" last="Attal">Michel Attal</name><affiliation wicri:level="3"><nlm:aff id="aff24">Service d'Hématologie, Hospital Purpan, Toulouse, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Service d'Hématologie, Hospital Purpan, Toulouse</wicri:regionArea><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Midi-Pyrénées</region><settlement type="city">Toulouse</settlement></placeName></affiliation></author></analytic><series><title level="j">Blood</title><idno type="ISSN">0006-4971</idno><idno type="eISSN">1528-0020</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Maintaining results of successful induction therapy is an important goal in multiple myeloma. Here, members of the International Myeloma Working Group review the relevant data. Thalidomide maintenance therapy after autologous stem cell transplantation improved the quality of response and increased progression-free survival (PFS) significantly in all 6 studies and overall survival (OS) in 3 of them. In elderly patients, 2 trials showed a significant prolongation of PFS, but no improvement in OS. A meta-analysis revealed a significant risk reduction for PFS/event-free survival and death. The role of thalidomide maintenance after melphalan, prednisone, and thalidomide is not well established. Two trials with lenalidomide maintenance treatment after autologous stem cell transplantation and one study after conventional melphalan, prednisone, and lenalidomide induction therapy showed a significant risk reduction for PFS and an increase in OS in one of the transplant trials. Maintenance therapy with single-agent bortezomib or in combination with thalidomide or prednisone has been studied. One trial revealed a significantly increased OS with a bortezomib-based induction and bortezomib maintenance therapy compared with conventional induction and thalidomide maintenance treatment. Maintenance treatment can be associated with significant side effects, and none of the drugs evaluated is approved for maintenance therapy. Treatment decisions for individual patients must balance potential benefits and risks carefully, as a widely agreed-on standard is not established.</p></div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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