Bibliographic record
Abstract
PURPOSE OF REVIEW: Autologous stem cell transplantation is now considered the standard of care in patients with multiple myeloma up to 65 years of age. Therefore, two questions have been recently addressed by cooperative groups: should autologous stem cell transplantation be offered to older patients, and is it possible to improve the results of autologous stem cell transplantation, especially with double autologous stem cell transplantation? The results of allogeneic transplantation remain disappointing, with a high transplant-related mortality rate, increasing the need to explore new strategies such as reduced-intensity conditioning. RECENT FINDINGS: A randomized Italian study confirms that two courses of intermediate-dose melphalan supported by autologous stem cell transplantation is superior to standard melphalan-prednisone even in patients aged 65 to 70. The Intergroupe Francophone du Myelome 94 (IFM94) trial shows that double transplantation is superior to single transplantation, at least in patients with less than 90% reduction of their M-component after one transplant. Several studies have addressed the issue of prognostic factors in the context of autologous stem cell transplantation. A prospective Dutch trial confirms poor results with T cell-depleted allogeneic transplantation prepared by a standard myeloablative regimen. The Seattle group, on the other hand, reports encouraging preliminary data with tandem auto/mini-allotransplantation. SUMMARY: The available results of randomized studies are in favor of tandem autologous transplantation. In the near future, ongoing studies will clarify the role of novel agents (thalidomide and its analogs, bortezomib) in the context of autologous stem cell transplantation and the place of tandem auto/mini-allotransplantation compared with tandem autologous transplantation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".