{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T10:58:43Z","timestamp":1770980323864,"version":"3.50.1"},"reference-count":38,"publisher":"American Society of Hematology","issue":"6","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2003,3,15]]},"abstract":"<jats:p>We compared the efficacy of intensified chemotherapy followed by myeloablative therapy and autologous stem cell rescue with intensified chemotherapy alone in patients newly diagnosed with multiple myeloma. There were 261 eligible patients younger than 66 years with stage II\/III multiple myeloma who were randomized after remission induction therapy with vincristine, adriamycin, dexamethasone (VAD) to receive intensified chemotherapy, that is, melphalan 140 mg\/m2 administered intravenously in 2 doses of 70 mg\/m2 (intermediate-dose melphalan [IDM]) without stem cell rescue (n\u2009=\u2009129) or the same regimen followed by myeloablative therapy consisting of cyclophosphamide, total body irradiation, and autologous stem cell reinfusion (n\u2009=\u2009132). Interferon-\u03b1\u20132a was given as maintenance. Of the eligible patients, 79% received both cycles of IDM and 79% of allocated patients actually received myeloablative treatment. The response rate (complete remission [CR] plus partial remission [PR]) was 88% in the intensified chemotherapy group versus 95% in the myeloablative treatment group. CR was significantly higher after myeloablative therapy (13% versus 29%; P\u2009=\u2009.002). With a median follow-up of 33 months (range, 8-65 months), the event-free survival (EFS) was not different between the treatments (median 21 months versus 22 months; P\u2009=\u2009.28). Time to progression (TTP) was significantly longer after myeloablative treatment (25 months versus 31 months; P\u2009=\u2009.04). The overall survival (OS) was not different (50 months versus 47 months; P\u2009=\u2009.41). Intensified chemotherapy followed by myeloablative therapy as first-line treatment for multiple myeloma resulted in a higher CR and a longer TTP when compared with intensified chemotherapy alone. However, it did not result in a better EFS and OS.<\/jats:p>","DOI":"10.1182\/blood-2002-03-0889","type":"journal-article","created":{"date-parts":[[2003,2,27]],"date-time":"2003-02-27T13:28:53Z","timestamp":1046352533000},"page":"2144-2151","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":119,"title":["Overall and event-free survival are not improved by the use of myeloablative therapy following intensified chemotherapy in previously untreated patients with multiple myeloma: a prospective randomized phase 3 study"],"prefix":"10.1182","volume":"101","author":[{"given":"Christine M.","family":"Segeren","sequence":"first","affiliation":[{"name":"From the Erasmus Medical Center Rotterdam (Erasmus MC) and University Medical Center Utrecht (UMCU) for the Dutch-Belgian Hemato-Oncology Cooperative Study Group (HOVON), The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pieter","family":"Sonneveld","sequence":"additional","affiliation":[{"name":"From the Erasmus Medical Center Rotterdam (Erasmus MC) and University Medical Center Utrecht (UMCU) for the Dutch-Belgian Hemato-Oncology Cooperative Study Group (HOVON), The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bronno","family":"van der Holt","sequence":"additional","affiliation":[{"name":"From the Erasmus Medical Center Rotterdam (Erasmus MC) and University Medical Center Utrecht (UMCU) for the Dutch-Belgian Hemato-Oncology Cooperative Study Group (HOVON), The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edo","family":"Vellenga","sequence":"additional","affiliation":[{"name":"From the Erasmus Medical Center Rotterdam (Erasmus MC) and University Medical Center Utrecht (UMCU) for the Dutch-Belgian Hemato-Oncology Cooperative Study Group (HOVON), The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra J.","family":"Croockewit","sequence":"additional","affiliation":[{"name":"From the Erasmus Medical Center Rotterdam (Erasmus MC) and University Medical Center Utrecht (UMCU) for the Dutch-Belgian Hemato-Oncology Cooperative Study Group (HOVON), The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregor E. G.","family":"Verhoef","sequence":"additional","affiliation":[{"name":"From the Erasmus Medical Center Rotterdam (Erasmus MC) and University Medical Center Utrecht (UMCU) for the Dutch-Belgian Hemato-Oncology Cooperative Study Group (HOVON), The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan J.","family":"Cornelissen","sequence":"additional","affiliation":[{"name":"From the Erasmus Medical Center Rotterdam (Erasmus MC) and University Medical Center Utrecht (UMCU) for the Dutch-Belgian Hemato-Oncology Cooperative Study Group (HOVON), The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martijn R.","family":"Schaafsma","sequence":"additional","affiliation":[{"name":"From the Erasmus Medical Center Rotterdam (Erasmus MC) and University Medical Center Utrecht (UMCU) for the Dutch-Belgian Hemato-Oncology Cooperative Study Group (HOVON), The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marinus H. J.","family":"van Oers","sequence":"additional","affiliation":[{"name":"From the Erasmus Medical Center Rotterdam (Erasmus MC) and University Medical Center Utrecht (UMCU) for the Dutch-Belgian Hemato-Oncology Cooperative Study Group (HOVON), The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre W.","family":"Wijermans","sequence":"additional","affiliation":[{"name":"From the Erasmus Medical Center Rotterdam (Erasmus MC) and University Medical Center Utrecht (UMCU) for the Dutch-Belgian Hemato-Oncology Cooperative Study Group (HOVON), The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wim E.","family":"Fibbe","sequence":"additional","affiliation":[{"name":"From the Erasmus Medical Center Rotterdam (Erasmus MC) and University Medical Center Utrecht (UMCU) for the Dutch-Belgian Hemato-Oncology Cooperative Study Group (HOVON), The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shulamit","family":"Wittebol","sequence":"additional","affiliation":[{"name":"From the Erasmus Medical Center Rotterdam (Erasmus MC) and University Medical Center Utrecht (UMCU) for the Dutch-Belgian Hemato-Oncology Cooperative Study Group (HOVON), The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harry C.","family":"Schouten","sequence":"additional","affiliation":[{"name":"From the Erasmus Medical Center Rotterdam (Erasmus MC) and University Medical Center Utrecht (UMCU) for the Dutch-Belgian Hemato-Oncology Cooperative Study Group (HOVON), The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marinus van Marwijk","family":"Kooy","sequence":"additional","affiliation":[{"name":"From the Erasmus Medical Center Rotterdam (Erasmus MC) and University Medical Center Utrecht (UMCU) for the Dutch-Belgian Hemato-Oncology Cooperative Study Group (HOVON), The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douwe H.","family":"Biesma","sequence":"additional","affiliation":[{"name":"From the Erasmus Medical Center Rotterdam (Erasmus MC) and University Medical Center Utrecht (UMCU) for the Dutch-Belgian Hemato-Oncology Cooperative Study Group (HOVON), The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joke W.","family":"Baars","sequence":"additional","affiliation":[{"name":"From the Erasmus Medical Center Rotterdam (Erasmus MC) and University Medical Center Utrecht (UMCU) for the Dutch-Belgian Hemato-Oncology Cooperative Study Group (HOVON), The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosalyn","family":"Slater","sequence":"additional","affiliation":[{"name":"From the Erasmus Medical Center Rotterdam (Erasmus MC) and University Medical Center Utrecht (UMCU) for the Dutch-Belgian Hemato-Oncology Cooperative Study Group (HOVON), The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monique M. 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Spanish Registry for Transplant in MM (Grupo Espanol de Trasplante Hematopoyetico-GETH) and PETHEMA.","volume":"21","author":"Alegre","year":"1998","journal-title":"Bone Marrow Transplant."},{"key":"2019111821214040400_B16","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1038\/sj.bmt.1701574","article-title":"Induction therapy with vincristine, adriamycin, dexamethasone (VAD) and intermediate-dose melphalan (IDM) followed by autologous or allogeneic stem cell transplantation in newly diagnosed multiple myeloma.","volume":"23","author":"Lokhorst","year":"1999","journal-title":"Bone Marrow Transplant."},{"key":"2019111821214040400_B17","first-page":"7","article-title":"Impact on survival of high-dose therapy with autologous stem cell support in patients younger than 60 years with newly diagnosed multiple myeloma: a population-based study. Nordic Myeloma Study Group.","volume":"95","author":"Lenhoff","year":"2000","journal-title":"Blood."},{"key":"2019111821214040400_B18","first-page":"141","article-title":"Autologous stem cell transplantation in multiple myeloma-an update of the EBMT registry.","volume-title":"VIII International Myeloma Workshop. Banff, Canada;","author":"Bjorkstrand","year":"2001"},{"key":"2019111821214040400_B19","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1056\/NEJM199607113350204","article-title":"A prospective, randomized trial of autologous bone marrow transplantation and chemotherapy in multiple myeloma. 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