IFM 2006 prospective trial: bortezomib-based induction and transplantation for primary plasma cell leukaemia
The first prospective trial dedicated to plasma cell leukaemia showed that a bortezomib-based four-drug induction followed by stem cell transplantation could produce remissions in most patients, though relapse remained the rule.
Overview
Phase 2 study of 40 patients with primary plasma cell leukaemia treated with bortezomib, doxorubicin, cyclophosphamide and dexamethasone induction followed by autologous transplant and, for those with a donor, reduced-intensity allogeneic transplant, or a second autologous transplant and maintenance.
Response after induction was 69 percent, median progression-free survival 15.1 months and median overall survival 36.3 months, a clear improvement on historical series with median survival under a year.
- Overall response 69 percent after induction.
- Median progression-free survival 15.1 months; median overall survival 36.3 months.
Bortezomib-based induction with early transplant consolidation became the accepted approach for fit patients with this rare aggressive disease; daratumumab-containing quadruplets are now added by extrapolation.
- Small single-arm study.
- Allogeneic transplant did not clearly improve outcomes compared with tandem autologous transplant.
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