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Transplantation does not benefit patients with refractory myeloma

05.06.2007
A study, led by Dr. Joan Bladé, researcher of the Haematooncology Group of Hospital Clínic-IDIBAPS (Barcelona), in collaboration with Dr. Laura Rosiñol, researcher of the same group, assessed the efficiency in terms of response and survival of autologous bone marrow transplantation in patients suffering from refractory myeloma previously having undergone high-dose chemotherapy (HDT). Results were conclusive; in patients suffering from resistant myeloma, neither did transplantation show any benefits nor increased survival.

This research work, conducted within the frame of the PETHEMA network, was carried out from October 1999 to December 2000. It was coordinated from Hospital Clínic, Barcelona and had the participation of the six following Spanish hospitals: Hospital Clínico de Salamanca, Hospital de Sant Pau, Hospital Son Dureta Palma de Mallorca, Hospital Universitario de Salamanca, Hospital Ramón y Cajal de Madrid, Hospital La Fe de Valencia. A total of 829 patients under 65 years and suffering from newly diagnosed multiple myeloma underwent 6 chemotherapy treatment cycles.

Firstly, researchers observed that approximately 10% of patients treated with chemotherapy did not respond to the therapy. The group of treated patients suffering from refractory myeloma was divided into two separately investigated subgroups. The first, formed by 62 % of the total number of patients, consisted of refractory patients presenting a stable, non-progressing disease. The second group, the remaining 38%, suffered from progressive disease.

Until now, it was believed that the fraction of patients which did not show any response to prior treatment was the most benefited group from subsequent transplantations. Nevertheless, results obtained by this trial unveiled a different idea. After conducting subsequent autologous bone marrow transplantations in all patients, researchers observed that refractory patients suffering from progressive myeloma did not show any benefit regarding survival. The disease progressed despite of the transplantation. On the other hand, the second group suffering from stable, non-progressive myeloma responded slightly and showed a life time expectancy of 5 more years. This last survival piece of data, a priori interesting, is very similar that obtained from the group of 718 patients which showed response to chemotherapy (HDT). Thus, it still remains to determine whether this improvement of survival in the second group is due to the transplantation, the chemotherapy treatment or to patient’s indolent myeloma.

About multiple myeloma

Multiple myeloma is a type of bone marrow cancer, consisting in abnormal proliferation of plasma cells –blood cells producing antibodies that help the body’s immune system fight disease. The treatment for this kind of cancer consists of a therapy provoking a decrease in tumour cells previous to successful autologous bone marrow stem cells transplantation.

The pre-transplantation therapy used until now made patients undergo chemotherapy.

Hospital Clínic at ASCO

The ASCO Annual Meeting, celebrated this year in Chicago from June 01 – 05 is considered to be the world’s most important event for the whole scientific community making research on issues related to cancer, which has more than 30,000 researchers. Every year thousands of articles from all over the world are presented at ASCO, reflecting the last clinical and translational research progress within the areas of prevention, diagnosis and treatment of cancer.

This year Hospital Clínic-IDIBAPS has played an important role. First of all due to the oral presentations of Dr. Laura Rosiñol and Joan Bladé, of the Haematooncology Group of Hospital Clínic-IDIBAPS, who have presented two studies about multiple myeloma, which will mean an important progress in the treatment of this disease and second due to the presentation within the plenary session of Dr Jordi Bruix and Dr. Josep María Llovet from the Hepatic Oncology Group of Hospital Clínic-IDIBAPS, exposing some unprecedented results about a therapy of liver cancer.

These events strengthen Hospital Clinic’s commitment in being an oncological reference hospital not only for the development of translational research, but also for patient health care.

Àlex Argemí Saburit | alfa
Further information:
http://www.hospitalclinic.org

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