TY - JOUR
T1 - Complete remission in multiple myeloma examined as time-dependent variable in terms of both onset and duration in Total Therapy protocols
AU - Hoering, Antje
AU - Crowley, John
AU - Shaughnessy, John D.
AU - Hollmig, Klaus
AU - Alsayed, Yazan
AU - Szymonifka, Jackie
AU - Waheed, Sarah
AU - Nair, Bijay
AU - Van Rhee, Frits
AU - Anaissie, Elias
AU - Barlogie, Bart
PY - 2009
Y1 - 2009
N2 - Landmark analyses are used to investigate the importance for survival of achieving complete response (CR), an important initial goal of myeloma therapy. With median times to CR in Total Therapy (TT) trials of approximately 1 year, this approach excludes a sizeable fraction of patients dying before such a landmark. To permit inclusion of all trial participants, we investigated the prognostic implications of both onset and duration of CR as time-dependent variables. Superseding the adverse effects of cytogenetic abnormalities and other standard prognostic parameters, both failure to achieve CR (non-CR) and, especially, loss of CR (los-CR) were independently associated with inferior survival in TT1, TT2, and TT3 protocols. In the context of gene array-defined risk, available in TT2 and TT3 subsets, both los-CR and non-CR terms were retained in the survival model as dominant adverse variables, stressing the prognostic importance of sustaining CR status, especially in high-risk disease.
AB - Landmark analyses are used to investigate the importance for survival of achieving complete response (CR), an important initial goal of myeloma therapy. With median times to CR in Total Therapy (TT) trials of approximately 1 year, this approach excludes a sizeable fraction of patients dying before such a landmark. To permit inclusion of all trial participants, we investigated the prognostic implications of both onset and duration of CR as time-dependent variables. Superseding the adverse effects of cytogenetic abnormalities and other standard prognostic parameters, both failure to achieve CR (non-CR) and, especially, loss of CR (los-CR) were independently associated with inferior survival in TT1, TT2, and TT3 protocols. In the context of gene array-defined risk, available in TT2 and TT3 subsets, both los-CR and non-CR terms were retained in the survival model as dominant adverse variables, stressing the prognostic importance of sustaining CR status, especially in high-risk disease.
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U2 - 10.1182/blood-2009-03-211953
DO - 10.1182/blood-2009-03-211953
M3 - Article
C2 - 19515721
AN - SCOPUS:70349320472
SN - 0006-4971
VL - 114
SP - 1299
EP - 1305
JO - Blood
JF - Blood
IS - 7
ER -