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, Stephen D Nimer

Research output: Contribution to journalArticle

8 Citations (Scopus)

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
Pages (from-to)345-349
Number of pages5
JournalLeukemia
Volume20
Issue number2
DOIs
StatePublished - Feb 1 2006
Externally publishedYes

Fingerprint

Carmustine
Melphalan
Stem Cell Transplantation
Multiple Myeloma
Disease-Free Survival
Lung
Salmon
Karyotype
Bone Marrow
Survival
Mortality
Therapeutics

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 journalArticle

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
Comenzo, R. L. ; Hassoun, H. ; Kewalramani, T. ; Klimek, V. ; Dhodapkar, M. ; Reich, L. ; Teruya-Feldstein, J. ; Fleisher, M. ; Filippa, D. ; Nimer, Stephen D. / Results of a phase I/II trial adding carmustine (300mg/m2) to melphalan (200mg/m2) in multiple myeloma patients undergoing autologous stem cell transplantation. In: Leukemia. 2006 ; Vol. 20, No. 2. pp. 345-349.
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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.",
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