Phase I-II study of busulfan and cyclophosphamide conditioning for transplantation in advanced multiple myeloma

G. Schiller, Stephen D Nimer, R. Vescio, G. Lieb, M. Lee, J. Gajewski, M. Territo, J. Berenson

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

We evaluated a non-radiation containing preparative regimen for persons with myeloma receiving bone marrow (BM) or blood cell transplants. Twenty-three adults with advanced multiple myeloma (15 responsive to chemotherapy, 8 resistant) received cyclophosphamide 120 mg/kg and busulfan 14-16 mg/kg followed by the infusion of BM or blood progenitor cells. Patients were followed for response by monthly skeletal radiographs, urine and serum monoclonal paraprotein measurement, BM evaluation and β2-microglobulin. Three of 18 evaluable patients achieved complete response, 13 patients achieved partial response and two a minimal response. Actuarial 1 year survival post-transplant for all patients is 63% (95% confidence interval, 40-86%). Disease stage and response to chemotherapy pre-transplant correlated with survival post-transplant. Actuarial survival for patients with resistant disease was 38% (4-72%); for patients with chemotherapy-responsive disease, it was 78% (48-100%, p = 0.02). Regimen-related toxicity consisted of five early deaths, three from veno-occlusive disease, one from infection and one from multiorgan failure. Fatal and non-fatal hepatic and renal toxicities were related to busulfan dose with most complications occurring at 16 mg/kg. Our studies suggest that busulfan and cyclophosphamide are an effective conditioning regimen in multiple myeloma. Toxicity precludes increasing the total dose of busulfan beyond 14 mg/kg.

Original languageEnglish
Pages (from-to)131-136
Number of pages6
JournalBone Marrow Transplantation
Volume14
Issue number1
StatePublished - Jan 1 1994
Externally publishedYes

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Transplantation Conditioning
Busulfan
Multiple Myeloma
Cyclophosphamide
Transplants
Drug Therapy
Survival
Blood Cells
Bone Marrow
Paraproteins
Bone Marrow Cells
Stem Cells
Urine
Confidence Intervals
Kidney
Liver
Infection
Serum

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Schiller, G., Nimer, S. D., Vescio, R., Lieb, G., Lee, M., Gajewski, J., ... Berenson, J. (1994). Phase I-II study of busulfan and cyclophosphamide conditioning for transplantation in advanced multiple myeloma. Bone Marrow Transplantation, 14(1), 131-136.

Phase I-II study of busulfan and cyclophosphamide conditioning for transplantation in advanced multiple myeloma. / Schiller, G.; Nimer, Stephen D; Vescio, R.; Lieb, G.; Lee, M.; Gajewski, J.; Territo, M.; Berenson, J.

In: Bone Marrow Transplantation, Vol. 14, No. 1, 01.01.1994, p. 131-136.

Research output: Contribution to journalArticle

Schiller, G, Nimer, SD, Vescio, R, Lieb, G, Lee, M, Gajewski, J, Territo, M & Berenson, J 1994, 'Phase I-II study of busulfan and cyclophosphamide conditioning for transplantation in advanced multiple myeloma', Bone Marrow Transplantation, vol. 14, no. 1, pp. 131-136.
Schiller, G. ; Nimer, Stephen D ; Vescio, R. ; Lieb, G. ; Lee, M. ; Gajewski, J. ; Territo, M. ; Berenson, J. / Phase I-II study of busulfan and cyclophosphamide conditioning for transplantation in advanced multiple myeloma. In: Bone Marrow Transplantation. 1994 ; Vol. 14, No. 1. pp. 131-136.
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