Haematologica (Jul 2007)

Intermediate-dose melphalan compared with myeloablative treatment in multiple myeloma: long-term follow-up of the Dutch Cooperative Group HOVON 24 trial

  • Pieter Sonneveld,
  • Bronno van der Holt,
  • Christine M. Segeren,
  • Edo Vellenga,
  • Alexandra J. Croockewit,
  • Gregor E.G. Verhoef,
  • Jan J. Cornelissen,
  • Martijn R. Schaafsma,
  • Marinus H.J. van Oers,
  • Pierre W. Wijermans,
  • Petra H.M. Westveer,
  • Henk M. Lokhorst

DOI
https://doi.org/10.3324/haematol.11168
Journal volume & issue
Vol. 92, no. 7

Abstract

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Background and Objectives The Dutch-Belgian HOVON group performed a randomized phase 3 trial to compare single non-myeloablative intensive treatment with double, intensive treatment in previously untreated patients with multiple myeloma (MM).Design and Methods Three hundred and three patients with stage II/III MM were randomized after VAD induction chemotherapy to receive two cycles of non-myeloablative intermediate-dose melphalan (70 mg/m2) (single treatment) or the same regimen followed by cyclophosphamide 120 mg/kg iv plus total body irradiation (TBI) 9 Gy and autologous stem cell transplantation (double, intensive treatment). In both treatment arms interferon αIIa was given as maintenance until relapse/progression.Results A significantly higher proportion of patients achieved a complete remission (CR) on protocol treatment with double, intensive therapy (32% vs 13%, p