Results of a phase I/II trial adding carmustine (300mg/m2) to melphalan (200mg/m2) in multiple myeloma patients undergoing autologous stem cell transplantation

R. L. Comenzo, H. Hassoun, T. Kewalramani, V. Klimek, M. Dhodapkar, L. Reich, J. Teruya-Feldstein, M. Fleisher, D. Filippa, S. D. Nimer

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Autologous stem cell transplantation (SCT) with high-dose melphalan (HDM, 200mg/m2) is the most effective therapy for multiple myeloma. To determine the feasibility of combining carmustine (300mg/m2) with HDM, we enrolled 49 patients with previously treated Durie -Salmon stage II/III myeloma (32M/17W, median age 53) on a phase I/II trial involving escalating doses of melphalan (160, 180, 200mg/m2). The median β2-microglobulin was 2.5 (0 -9.3); marrow karyotypes were normal in 88%. The phase I dose-limiting toxicity was >grade 2 pulmonary toxicity 2 months post-SCT. Other endpoints were response rate and progression-free survival (PFS). HDM was safely escalated to 200mg/m2; treatment-related mortality was 2% and >grade 2 pulmonary toxicity 10%. The complete (CR) and near complete (nCR) response rate was 49%. With a median post-SCT follow-up of 2.9 years, the PFS and overall survival (OS) post-SCT were 2.3 and 4.7 years. PFS for those with CR or nCR was 3.1 years while for those with stable disease (SD) it was 1.3 years (P =0.06). We conclude that carmustine can be combined with HDM for myeloma with minimal pulmonary toxicity and a high response rate.

Original languageEnglish (US)
Pages (from-to)345-349
Number of pages5
JournalLeukemia
Volume20
Issue number2
DOIs
StatePublished - Feb 2006
Externally publishedYes

Keywords

  • Carmustine
  • Melphalan
  • Myeloma
  • Pulmonary
  • Stem cells
  • Transplantation

ASJC Scopus subject areas

  • Hematology
  • Cancer Research

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    Comenzo, R. L., Hassoun, H., Kewalramani, T., Klimek, V., Dhodapkar, M., Reich, L., Teruya-Feldstein, J., Fleisher, M., Filippa, D., & Nimer, S. D. (2006). Results of a phase I/II trial adding carmustine (300mg/m2) to melphalan (200mg/m2) in multiple myeloma patients undergoing autologous stem cell transplantation. Leukemia, 20(2), 345-349. https://doi.org/10.1038/sj.leu.2404003