Alpha-interferon maintenance treatment is associated with improved survival after high-dose treatment and autologous stem cell transplantation in patients with multiple myeloma: a retrospective registry study from the European Group for Blood and Marrow Transplantation (EBMT)

Björkstrand, Bo; Svensson, H.; Goldschmidt, Hartmut; Ljungman, Per; Apperley, Jane F.; Mandelli, Franco; Marcus, Robert; Boogaerts, Marc; Alegre, Adrián; Remes, Kari; Cornelissen, Jan J.; Bladé, Joan; Lenhoff, Stig; Iriondo, A; Carlson, Kristina; Volin, Liisa; Littlewood, Tim; Goldstone, Anthony H.; Miguel, Jesús F. San; Schattenberg, A.V.M.B.; Gahrton, Gösta

doi:10.1038/sj.bmt.1702826

Cited by 87 publications

(38 citation statements)

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“…However the survival benefit, if any, may be small and needed to be balanced against cost and added toxicity [30]. A retrospective analysis from the European Group for Blood and Marrow Transplantation showed a clear survival benefit for patients who received interferon maintenance after autologous SCT for multiple myeloma [31]. However, according to the authors of this study, part of the difference may be related to other differences in prognostic factors and further studies appeared warranted.…”

Section: Discussionmentioning

confidence: 53%

Primary plasma cell leukemia: Report of 17 new cases treated with autologous or allogeneic stem‐cell transplantation and review of the literature

et al. 2005

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Primary plasma cell leukemia (PPCL) is a rare hematologic malignancy characterized by the proliferation of plasma cells in blood, bone marrow, and other organs in the absence of established multiple myeloma. PPCL has a poor prognosis when treated with conventional therapy for multiple myeloma. We describe here 17 new cases of PPCL who underwent stem-cell transplantation (SCT) (2 cases observed by the authors and 15 cases from the International Bone Marrow Transplant Registry [IBMTR]). The first case was diagnosed in a 21-year-old male who presented with leukocytosis and acute renal failure. He was treated with hyper-CVAD, entered complete remission, and then proceeded to high-dose chemotherapy with peripheral stem-cell support. He is currently in complete remission 23 months after initial diagnosis and 19 months after autologous SCT. The second case was observed in a 31-yearold male who presented with leukocytosis and hepatic infiltration with plasma cells. He was treated with VAD chemotherapy and underwent allogeneic bone marrow transplantation from his HLA-identical sister. He remained in complete remission for 3 years and then developed progressive refractory disease, dying 7 years after the initial diagnosis. In addition to these 2 cases, 15 further unpublished cases of PPCL from the IBMTR are reported here (treated between 1993 and 2001, 6 by autologous and 9 by allogeneic transplantation). Finally, the features of PPCL, the outcome, published data of SCT for PPCL, and indications for treatment are discussed. Am.

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Section: Discussionmentioning

confidence: 53%

Primary plasma cell leukemia: Report of 17 new cases treated with autologous or allogeneic stem‐cell transplantation and review of the literature

et al. 2005

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“…Suitable drugs include interferon, which has been described to prolong remissions in myeloma following autografting. 22,23 Malignant cells are more frequently CD20-positive in PCL than in myeloma 2 which may indicate a role for anti-CD20 monoclonal antibody in initial or maintenance therapy. Thalidomide has been used in induction therapy alone and in combination 24 and may be a useful maintenance agent after autologous transplantation.…”

Section: Discussionmentioning

confidence: 99%

Primary plasma cell leukemia and autologous stem cell transplantation

Drake

Iacobelli²,

Biezen³

et al. 2010

Haematologica

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“…Furthermore, the difference in overall survival and progression-free survival was shown to be more evident among patients who achieved a partial response after autologous bone marrow transplantation than among those who achieved a complete response. 41 Side effects related to IFN therapy usually are reversible and are comprised mainly of flu-like symptoms and occasionally anemia, leukocytopenia, thrombocytopenia, an increase in the transaminase or creatinine serum level, weight loss, dermatitis, itching, and involvement of the peripheral nervous system. A particular note must be made concerning the effects of IFN-␣ on serum ␤ 2 microglobulin.…”

Section: Immunotherapy Of Multiple Myelomamentioning

confidence: 99%

A review of the cytokine network in multiple myeloma

Lauta

2003

Cancer

197

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Because many studies have focused on growth factors in multiple myeloma, the study of the cytokine network appears to be useful for this purpose. Interleukin-6 (IL-6) and IL-2 with their soluble receptors (IL-3, IL-4, IL-10, and IL-11) have been examined. Plasma cells may produce IL-6 by an autocrine mechanism whereas a paracrine mechanism is believed to be involved in the production of IL-6 by bone However, the concomitant evaluation of all immunologic parameters could be more useful than the value of a single IL. Serum levels of IL-6, sIL-6R, sIL-2R, and the expression of membrane-bound IL-2 receptors, both on bone marrow plasma cells and on peripheral blood mononuclear cells, are correlated with disease activity and disease stage. In addition, IL-6 and sIL-6R serum levels are believed to be correlated with the duration of disease-free survival because a high serum level at the time of diagnosis is believed to be correlated with a short duration of survival. However, some laboratory parameters may express the same prognostic value as high ␤ 2 microglobulin and lactate dehydrogenase (LDH) serum levels together with a high plasma cell labeling index are correlated with disease activity.Furthermore, if the evaluation is performed at the time of diagnosis, high values of these parameters are correlated with a short disease-free survival. A correlation between laboratory parameters and the serum level of several cytokines was demonstrated. Hence, the real advantage of the prognostic evaluation of cytokines is reserved for patients who do not exhibit uniform results with regard to ␤ 2 microglobulin and LDH serum levels, or, better, for borderline cases. With regard to the differential diagnosis, all immunologic parameters should be evaluated concomitantly rather than separately to confer a real prognostic value to results. Furthermore, a particular relation was found between a high sIL-6R serum level and a poor response to chemotherapy, therefore suggesting the possibility of identifying in advance a subset of patients with a high risk of treatment failure, as has already been demonstrated in other hematologic malignancies.Finally, the majority of studies indicate that interferons are used mainly in the immunotherapy for multiple myeloma, whereas many clinical trials should still be required for the evaluation of the effectiveness of anti-I-L6 antibodies or antiidiotypic vaccines in reference to the eligible patients for these particular therapies.

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Alpha-interferon maintenance treatment is associated with improved survival after high-dose treatment and autologous stem cell transplantation in patients with multiple myeloma: a retrospective registry study from the European Group for Blood and Marrow Transplantation (EBMT)

Cited by 87 publications

References 23 publications

Primary plasma cell leukemia: Report of 17 new cases treated with autologous or allogeneic stem‐cell transplantation and review of the literature

Primary plasma cell leukemia: Report of 17 new cases treated with autologous or allogeneic stem‐cell transplantation and review of the literature

Primary plasma cell leukemia and autologous stem cell transplantation

A review of the cytokine network in multiple myeloma

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