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- Title
Acute lymphoblastic leukaemia-type intensive chemotherapy to eliminate minimal residual disease after high-dose melphalan and autologous transplantation in multiple myeloma – a phase I/II feasibility and tolerance study of 17 patients.
- Authors
Powles, R; Sirohi, B; Kulkarni, S; Bhagwati, N; Saso, R; Raje, N; Horton, C; Singhal, S; Mehta, J; Treleaven, J
- Abstract
Aiming to target the minimal residual disease in patients with multiple myeloma, a phase I/II single centre study was undertaken for feasibility and tolerance of intensive acute lymphoblastic leukaemia consolidation chemotherapy (ALL-IC) as part of a strategy for post-transplant consolidation targeted at pre-B cells. Seventeen newly diagnosed patients with myeloma (median age 55 years; 30–65) were initially treated with courses of infused cyclophosphamide, vincristine, adriamycin and methylprednisolone (C-VAMP) followed by melphalan 200 mg/m2(HDM) and peripheral blood stem cell rescue (PBSC). Forty-seven percent were in CR and the rest in PR after HDM. ALL-IC consisted of vincristine, daunorubicin, etoposide, cytarabine, 6-thioguanine and prednisolone given over 5 days. All patients became neutropenic (<0.5 × 109/l) at a median of 10 days (4–18) and one of the 17 patients (5.8%) died 15 days post ALL-IC of sepsis. A further four have died of relapse with an overall survival (OS) of 67% at 4 years. Two of nine patients in PR at the time of ALL-IC achieved CR. Matched-pair analysis of 34 control patients shows no difference for OS and event-free survival between ALL-IC and controls. We conclude that ALL-IC given to myeloma patients after HDM/PBSC is as safe as when used in ALL and warrants further assessment in randomised trials for myeloma. Bone Marrow Transplantation (2000) 25, 949–956.
- Subjects
LYMPHOBLASTIC leukemia; DRUG therapy; B cells
- Publication
Bone Marrow Transplantation, 2000, Vol 25, Issue 9, p949
- ISSN
0268-3369
- Publication type
Article
- DOI
10.1038/sj.bmt.1702379