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 language | English |
|---|---|
| Pages (from-to) | 345-349 |
| Number of pages | 5 |
| Journal | Leukemia |
| Volume | 20 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 1 2006 |
| Externally published | Yes |
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Keywords
- Carmustine
- Melphalan
- Myeloma
- Pulmonary
- Stem cells
- Transplantation
ASJC Scopus subject areas
- Hematology
- Cancer Research
Cite this
Results of a phase I/II trial adding carmustine (300mg/m2) to melphalan (200mg/m2) in multiple myeloma patients undergoing autologous stem cell transplantation. / Comenzo, R. L.; Hassoun, H.; Kewalramani, T.; Klimek, V.; Dhodapkar, M.; Reich, L.; Teruya-Feldstein, J.; Fleisher, M.; Filippa, D.; Nimer, Stephen D.
In: Leukemia, Vol. 20, No. 2, 01.02.2006, p. 345-349.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Results of a phase I/II trial adding carmustine (300mg/m2) to melphalan (200mg/m2) in multiple myeloma patients undergoing autologous stem cell transplantation
AU - Comenzo, R. L.
AU - Hassoun, H.
AU - Kewalramani, T.
AU - Klimek, V.
AU - Dhodapkar, M.
AU - Reich, L.
AU - Teruya-Feldstein, J.
AU - Fleisher, M.
AU - Filippa, D.
AU - Nimer, Stephen D
PY - 2006/2/1
Y1 - 2006/2/1
N2 - 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.
AB - 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.
KW - Carmustine
KW - Melphalan
KW - Myeloma
KW - Pulmonary
KW - Stem cells
KW - Transplantation
UR - http://www.scopus.com/inward/record.url?scp=31444432053&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=31444432053&partnerID=8YFLogxK
U2 - 10.1038/sj.leu.2404003
DO - 10.1038/sj.leu.2404003
M3 - Article
VL - 20
SP - 345
EP - 349
JO - Leukemia
JF - Leukemia
SN - 0887-6924
IS - 2
ER -