The role of cytotoxic therapy with hematopoietic stem cell transplantation in the therapy of multiple myeloma: An evidence-based review  Theresa Hahn,

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Presentation transcript:

The role of cytotoxic therapy with hematopoietic stem cell transplantation in the therapy of multiple myeloma: An evidence-based review  Theresa Hahn, John R. Wingard, Kenneth C. Anderson, William I. Bensinger, James R. Berenson, Greg Brozeit, Joseph R. Carver, Robert A. Kyle, Philip L. McCarthy  Biology of Blood and Marrow Transplantation  Volume 9, Issue 1, Pages 4-37 (January 2003) DOI: 10.1053/bbmt.2003.50002

Fig. 1. Overall survival according to treatment group Fig. 1. Overall survival according to treatment group. The numbers shown below the time points are probabilities of overall survival (the percentages of patients surviving) and 95% confidence intervals. Reprinted with permission [3]. Biology of Blood and Marrow Transplantation 2003 9, 4-37DOI: (10.1053/bbmt.2003.50002)

Fig. 2. Superior EFS (top) and OS (bottom) among 116 newly diagnosed patients receiving “total therapy” (TT) compared with 116 closely matched “pair mates” receiving standard therapy according to SWOG protocols. The median times of follow-up of living patients on TT and SWOG studies are 31 and 63 months, respectively. Reprinted with permission [4]. Biology of Blood and Marrow Transplantation 2003 9, 4-37DOI: (10.1053/bbmt.2003.50002)

Fig. 3. Survival for the intensive therapy group and the control group Fig. 3. Survival for the intensive therapy group and the control group. The numbers shown below the time points are probabilities of survival in percent, with 95% confidence intervals in brackets. Reprinted with permission [5]. Biology of Blood and Marrow Transplantation 2003 9, 4-37DOI: (10.1053/bbmt.2003.50002)

Fig. 4. Partitioned Kaplan-Meier survival curves according to treatment group, ie, early HDT group (top) and late HDT group (bottom). Each plot displays the Kaplan-Meier estimations of time to OS, EFS, and time to end of treatment, either conventional chemotherapy (CCT) or transplantation (HDT), since randomization. Note that 2 EFS were considered in the late HDT group (after conventional chemotherapy, “post-CCT,” and after transplantation, “post-HDT”). The areas between these curves and the vertical line at 58 months, which corresponds to the median follow-up of the whole cohort, represent estimates of the mean durations between these events, namely treatment duration (either CCT [●] or HDT [+]), time without symptoms and treatment toxicity (TWISTT [●]), and time between relapse and death (▨). All patients were included in the analysis on an intent-to-treat basis. IFN was not taken into account because it was usually maintained only when well-tolerated. Reprinted with permission [13]. Biology of Blood and Marrow Transplantation 2003 9, 4-37DOI: (10.1053/bbmt.2003.50002)

Fig. 5. Kaplan-Meier probability of progression-free survival of 188 patients on an intent-to-treat basis. Reprinted with permission [51]. Biology of Blood and Marrow Transplantation 2003 9, 4-37DOI: (10.1053/bbmt.2003.50002)

Fig. 6. Survival according to treatment arm Fig. 6. Survival according to treatment arm. Reprinted with permission [73]. Biology of Blood and Marrow Transplantation 2003 9, 4-37DOI: (10.1053/bbmt.2003.50002)

Fig. 7. Event-free survival according to treatment arm Fig. 7. Event-free survival according to treatment arm. Reprinted with permission [73]. Biology of Blood and Marrow Transplantation 2003 9, 4-37DOI: (10.1053/bbmt.2003.50002)

Fig. 8. Probability of progression-free survival of all patients by the Kaplan-Meier method. Reprinted with permission [138]. Biology of Blood and Marrow Transplantation 2003 9, 4-37DOI: (10.1053/bbmt.2003.50002)