الفهرس | Only 14 pages are availabe for public view |
Abstract A lthough studies have illustrated a benefit in both progression-free survival (PFS) and overall survival (OS) conferred by the use of ASCT, almost all patients eventually relapse after transplantation. Because of this high rate of relapse as well as the observed correlation between the depth of response achieved and overall outcome, several groups have investigated the role of maintenance therapy after ASCT to achieve a durable remission and delay disease progression. Although many studies evaluating the role of maintenance therapy indicate a clear PFS advantage, the benefit to OS remains unclear. We conducted this study to assess the results of maintenance treatment with lenalidomide or bortezomib in multiple myeloma post autologous stem cell transplantation Our results showed that; This study revealed that, the highest survival rate at 1 year was (98.6%). Then at 3 years was (74.1%) and finally at 5 years was (18.7%). The highest PFS was at 1 year as reported in (78.4%) of cases, then at 2 years in (36.2%). As regard overall survival rate (OSR), patients received maintenance treatment was significantly better than patients who did not receive maintenance treatment. And also patients who received Lenalidomide ware significantly better than patients who received Bortezomib (p=0.005). As the median of Lenalidomide was 58 months, Bortezomib was 48 months and No maintenance was 28 months As regard disease free survival (PFS) (months), patients who received maintenance treatment were significantly better than patients who did not receive maintenance treatment. And also patients who received Lenalidomide ware significantly better than patients who received Bortezomib (p=0.018). As the median of Lenalidomide was 30 months, Bortezomib was 22 months and No maintenance was 14 months. The majority of patients had no complications (85.4%). 28% of patients received bortezomib had developed complications and 85.7% of them had peripheral neuropathy then viral infections in (4%) of them. Also it was noticed that 16% of patients received lenalidomide had developed complications and 75% of them had immunosuppressive complications. With statistically significant between bortezomib and lenalidomide in incidence of complication and type of complication This study revealed that, there was insignificant differences in PFS & OSR as regard to Cytogenetic risk as p=0.969 &p=0.385 respectively. This study revealed that, there was insignificant differences in PFS & OSR as regard to disease status before transplantation as p=0.902 & 0.87 respectively. This study revealed that, there was insignificant differences in PFS & OSR regard to complications as p=0.209& p=0.224 respectively. |