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Sydney 2005: Double v Single ASCT & Role of Added Thal as First-line Tx for MM (Bologna 96 and 02)
By Michele Cavo, MD
04.13.05
Dr. Cavo offered findings from the Bologna 96 trial (the Italian study), which addressed the issue of single versus double autologous transplantation for patients younger than 60 years of age. At a median follow up of 55 months, double transplantation prolonged the median CR, EFS, and OS. The greatest benefit of double transplant was among patients who failed at least a near CR after first transplant. Dr. Cavo introduced the Bologna 2002 trials which evaluate the efficacy and toxicity of thalidomide-dexamethasone (thal/dex) as primary therapy for patients who are candidates from double autologous transplantation. Preliminary analysis of 100 patients was compared to 100 patients from the Bologna 96 trial. Patients matched in age and other baseline characteristics. Dr. Cavo cautioned the interpretation of data but shared that PR was higher in the thal/dex arm. Thal/dex was also found to significantly reduce tumor cell mass, but carried the higher risk of thrombosis requiring prophylaxis therapy. With this preliminary analysis, thal/dex did not adversely affect SCT collection. Dr. Cavo concluded that thal/dex may provide an easy to administer alternative to standard therapies.


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