EARLY MYELOABLATIVE THERAPY FOR MULTIPLE-MYELOMA

The value of early myeloablative therapy supported by autologous bone marrow or blood progenitor cells was assessed in 72 patients with mult iple myeloma who were treated within 1 year of initial therapy, Forty- five patients were consolidated during remission, and 27 patients were treated for primary refractory disease, Outcomes were compared with t hose of similar patients who did not receive intensive treatment prima rily for socioeconomic reasons, Among patients who had responded previ ously, myeloablative therapy increased the rate of complete remission from 5% to 45% (P < .01) but did not prolong progression-free interval s or survival times, The same treatment controlled the myeloma in 70% of patients with primary resistant disease and prolonged the median su rvival from 37 to 83 months (P = .03), Intensive treatment for primary resistant myeloma administered later in the disease course resulted i n significantly lower response rates and shorter progression-free inte rvals, Current myeloablative regimens supported by autologous stem cel ls appeared useful primarily in patients with primary resistant diseas e during the first year of therapy. (C) 1994 by The American Society o f Hematology.