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

doi:10.1038/sj.leu.2404003

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 journal › Article › peer-review

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 language	English (US)
Pages (from-to)	345-349
Number of pages	5
Journal	Leukemia
Volume	20
Issue number	2
DOIs	https://doi.org/10.1038/sj.leu.2404003
State	Published - Feb 2006
Externally published	Yes

Keywords

Carmustine
Melphalan
Myeloma
Pulmonary
Stem cells
Transplantation

ASJC Scopus subject areas

Hematology
Cancer Research

Access to Document

10.1038/sj.leu.2404003

Fingerprint Dive into the research topics of 'Results of a phase I/II trial adding carmustine (300mg/m<sup>2</sup>) to melphalan (200mg/m<sup>2</sup>) in multiple myeloma patients undergoing autologous stem cell transplantation'. Together they form a unique fingerprint.

Cite this

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

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, S. D.

In: Leukemia, Vol. 20, No. 2, 02.2006, p. 345-349.

Research output: Contribution to journal › Article › peer-review

Comenzo, RL, Hassoun, H, Kewalramani, T, Klimek, V, Dhodapkar, M, Reich, L, Teruya-Feldstein, J, Fleisher, M, Filippa, D & Nimer, SD 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, vol. 20, no. 2, pp. 345-349. https://doi.org/10.1038/sj.leu.2404003

@article{0f4219e19a3c411f8b802e0ce567ecd0,

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

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.",

keywords = "Carmustine, Melphalan, Myeloma, Pulmonary, Stem cells, Transplantation",

author = "Comenzo, {R. L.} and H. Hassoun and T. Kewalramani and V. Klimek and M. Dhodapkar and L. Reich and J. Teruya-Feldstein and M. Fleisher and D. Filippa and Nimer, {S. D.}",

note = "Funding Information: We thank the nursing staff and nurse practitioners in the out-patient clinics and particularly on MSKCC Medical 11 for the care they provide to our patients, and the MSKCC hematology fellows who have participated in the care of these patients. Grants and Support: This work was supported by NIH Grant CA05826, FDA Grant R03-002174, the Graziano Fund, the Mel Stottlemyre Myeloma Research Fund, the Donald Stein Myeloma Research Fund, and the Werner and Elaine Dannheiser Fund for Research on the Biology of Aging of the Lymphoma Foundation.",

year = "2006",

month = feb,

doi = "10.1038/sj.leu.2404003",

language = "English (US)",

volume = "20",

pages = "345--349",

journal = "Leukemia",

issn = "0887-6924",

publisher = "Nature Publishing Group",

number = "2",

}

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, S. D.

N1 - Funding Information: We thank the nursing staff and nurse practitioners in the out-patient clinics and particularly on MSKCC Medical 11 for the care they provide to our patients, and the MSKCC hematology fellows who have participated in the care of these patients. Grants and Support: This work was supported by NIH Grant CA05826, FDA Grant R03-002174, the Graziano Fund, the Mel Stottlemyre Myeloma Research Fund, the Donald Stein Myeloma Research Fund, and the Werner and Elaine Dannheiser Fund for Research on the Biology of Aging of the Lymphoma Foundation.

PY - 2006/2

Y1 - 2006/2

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

C2 - 16319952

AN - SCOPUS:31444432053

VL - 20

SP - 345

EP - 349

JO - Leukemia

JF - Leukemia

SN - 0887-6924

IS - 2

ER -