Over the past 10 years, there has been substantial progress in the treatment of
MM, prospective TGFbeta inhibitor randomized trials have shown the superiority of high-doses of chemotherapy with autologous stem cell transplantation (HDT/ASCT) over standard therapy (CT) and new drugs, such as immunomodulatory agents and proteasome inhibitors, have shown effectiveness against disease. These developments may have led to changes in the outcomes of IgD MM. In this report we present the results of a retrospective analysis of 17 cases with IgD MM treated with CT or HDT/ASCT in six institutions of Multiple myeloma Latium-Region GIMEMA Working Group between 1993 and 2009. Design and methods A retrospective analysis
was carried out of 17 patients with IgD MM diagnosed from 1993 to 2009 in six institutions from Multiple Myeloma Latium-Region GIMEMA Working Group. Patients who had overt MM based on International Myeloma Working Group (IMWG) diagnostic criteria were selected. Definition of response Selleckchem Captisol disease response was assessed using the IMWG criteria [16, 17]. Briefly, a partial response (PR) was defined as a 50% or higher decrease in the serum monoclonal protein (M-protein) levels from baseline and a reduction 90% or greater in 24 hour urine M-protein excretion or less than 200 mg/24 hours; a very good partial respone RXDX-101 mw (VGPR) required a 90% or greater reduction
in serum M-protein and urinary M-protein less than 100 mg/24 hours or M-protein detectable by immunofixation but not by electrophoresis. A complete response (CR) was defined as negative serum and urine immunofixation and less than 5% DNA ligase plasma cells on bone marrow examination. Disease that did not satisfy the criteria for PR, VGPR, CR or progressive disease was classified as stable disease (SD). Disease progression required any of the following: 25% or greater increase from lowest response value in serum M-protein (absolute ≥ 0.5 gr/dl) or urine M-protein (absolute ≥ 200 mg/24 hours). Progression free survival (PFS) was calculated from start of first treatment to disease progression or death from any cause, or the date the patient was last known to be in remission. Overall survival (OS) was calculated from start of first treatment to the date of death or the date the patient was last known to be alive. Duration of response (DOR) was calculated from the time of first response achievement, that is at least PR, to the time of disease progression, with deaths owing to causes other than progression not counted, but censored. For the analysis of treatment responses, PFS and OS, the patients were divided into two groups: one group was treated with HDT/ASCT, the other group received treatment with conventional-dose chemotherapy.