Benefit of Complete Response in Multiple Myeloma Limited to High - Risk Subgroup Identified by Gene Expression Profiling

  • Haessler J
  • Shaughnessy J
  • Zhan F
 et al. 
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Abstract

See, stats, and : https : / / www . researchgate . net / publication / 5792363 Benefit Myeloma - Risk Identified Article DOI : 10 . 1158 / 1078 - 0432 . CCR - 07 - 0527 : PubMed CITATIONS 71 READS 24 15 , including : Some : multiple Growth Antje Cancer 113 , 389 SEE Guido University 440 , 080 SEE Bart University 814 , 431 SEE All . The . All - text and , letting . Abstract Experimental Design : To determine whether the clinical benefit of complete remission (CR) may depend on prognostic subgroups of patients with multiple myeloma . Patients and Methods : Newly diagnosed patients with myeloma received a tandem auto - transplant regimen . Using multivariate regression analyses , we examined the prognostic impli - cations of time - dependent onset of CR on overall survival and event - free survival in the context of standard prognostic factors (SPF) and gene expression profiling ^ derived data available for 326 patients . Results : CR benefited patients regardless of risk status when only SPFs were examined . With knowledge of gene array data , a survival (and event - free survival) benefit of CR only pertained to the small high - risk subgroup of 13% of patients (hazard ratio , 0 . 23 ; P = 0 . 001) , whereas the majority of patients with low - risk disease had similar survival expectations whether or not CR was achieved (hazard ratio , 0 . 68 ; P = 0 . 128) . Conclusions : Access to gene expression information permitted the recognition of a small very high - risk subgroup of 13% of patients , in whom prolonged survival critically depended on achieving CR . Absence of such benefit in the remainder should lead to a reassessment of clinical trial designs that rely on this end point as a surrogate for long - term prognosis .

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Authors

  • Jeffrey Haessler

  • John D Shaughnessy

  • Fenghuang Zhan

  • John Crowley

  • Joshua Epstein

  • Frits Van Rhee

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