Background: Bortezomib and thalidomide have shown synergy with melphalan and dexamethasone. We used this 4-drug combination as conditioning before autologous hematopoietic cell infusions. Patients and methods: Twenty-six patients with advanced-stage myeloma were treated with melphalan 50 mg/m2 and bortezomib 1.3 mg/m2 on days -6 and -3 in association with thalidomide 200 mg and dexamethasone 20 mg on days -6 through -3, followed by hematopoietic cell support on day 0. Results: Nonhematologic toxicities included pneumonia, febrile neutrope nia, and peripheral neuropathy. All patients had undergone autologous transplantation at diagnosis, and 13 patients (50%) underwent an additional transplantation at relapse. Responses occurred in 17 of 26 patients (65%), including 1 complete remission, 3 near complete remissions (12%), and 2 very good partial remissions (8%). Response rate was higher than that induced by the previous line of treatment in 12 patients (46%). Conclusion: Melphalan/bortezomib/thalidomide/dexamethas one showed encouraging antimyeloma activity in patients with advanced-stage myeloma.
Intermediate-dose melphalan (100 mg/m2)/bortezomib/thalidomide/dexamethasone and stem cell support in patients with refractory or relapsed myeloma
Musto P.;
2006-01-01
Abstract
Background: Bortezomib and thalidomide have shown synergy with melphalan and dexamethasone. We used this 4-drug combination as conditioning before autologous hematopoietic cell infusions. Patients and methods: Twenty-six patients with advanced-stage myeloma were treated with melphalan 50 mg/m2 and bortezomib 1.3 mg/m2 on days -6 and -3 in association with thalidomide 200 mg and dexamethasone 20 mg on days -6 through -3, followed by hematopoietic cell support on day 0. Results: Nonhematologic toxicities included pneumonia, febrile neutrope nia, and peripheral neuropathy. All patients had undergone autologous transplantation at diagnosis, and 13 patients (50%) underwent an additional transplantation at relapse. Responses occurred in 17 of 26 patients (65%), including 1 complete remission, 3 near complete remissions (12%), and 2 very good partial remissions (8%). Response rate was higher than that induced by the previous line of treatment in 12 patients (46%). Conclusion: Melphalan/bortezomib/thalidomide/dexamethas one showed encouraging antimyeloma activity in patients with advanced-stage myeloma.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
