| pubmed-article:21699382 | pubmed:abstractText | In myeloma, achievement of very good partial response (VGPR) post-transplant is associated with prolonged overall (OS) and progression-free survival (PFS). In this study of bortezomib, pegylated liposomal doxorubicin, and dexamethasone (VDD) in 40 patients with newly diagnosed myeloma (median follow-up 45.1 months), 2-/4-year OS estimates were 95.7%/86.5% versus 82.4%/58.2% for patients achieving ?VGPR versus?<VGPR to VDD (p=0.0241). In 30 patients undergoing transplant, PFS (p?=?0.0357) and OS (p?=?0.0272) were longer in patients achieving ?VGPR to VDD. Achievement of ?VGPR was predicted by a novel model based on occurrence after two cycles of ?90% involved free light chain reduction, free light kappa/lambda ratio normalization, and/or ?90% M-protein reduction. Prediction of ?VGPR was associated with superior PFS and OS in patients with transplant. These findings emphasize the importance of achieving ?VGPR to initial therapy, associated with prolonged OS. The predictive model provides a potential basis for developing individualized therapy, which requires further study. | lld:pubmed |
