Liposomal daunorubicin and dexamethasone as a treatment for multiple myeloma--the DD Protocol.

Autor:	Dulley FL; Hospital Sírio-Libanês, São Paulo, Brazil. fldulley@usp.br, Saboya R, Hungria VT, Bueno ND, Mello FG, Frota MT, Chiattone CS, Barros JC, Mori NS, Sturaro D, Macedo MC, Silva RL, Melo LM, Souza CA
Jazyk:	angličtina
Zdroj:	Sao Paulo medical journal = Revista paulista de medicina [Sao Paulo Med J] 2005 Nov 03; Vol. 123 (6), pp. 266-70. Date of Electronic Publication: 2006 Jan 20.
DOI:	10.1590/s1516-31802005000600003
Abstrakt:	Context and Objective: Liposomal daunorubicin has been used to treat hematological malignancies, including multiple myeloma (MM). The goal was to evaluate efficacy, side-effects and toxicity of liposomal daunorubicin and dexamethasone ("DD Protocol"). Design and Setting: Prospective study at Sírio-Libanês, São Camilo, Brasil and Alemão Oswaldo Cruz hospitals. Methods: Twenty consecutive patients with active MM received four cycles of liposomal daunorubicin intravenously for two hours (25-30 mg/m(2)/day) on three consecutive days per month, with oral dexamethasone (10 mg every six hours) on four consecutive days three times a month. Results: The male/female ratio was 1:1 and median age 60. Nine patients were stage IIA, ten IIIA and one IIIB. The median from diagnosis to starting DD was 13 months. All patients received four cycles, except one. Fifteen had already received chemotherapy before DD. Responses of > 50% reduction in serum monoclonal paraprotein were observed in six patients after first cycle (30%), six after second (30%) and four after third (20%), while four (20%) did not obtain this. Initially, 17 patients (85%) had anemia: 12 (70%) achieved correction. Progressive disease was observed in three patients (15%), while one had minimal response, four (20%) partial and 12 (60%) complete. Hematological toxicity was acceptable: three patients (15%) had neutrophils < 1,000/mm(3); none had thrombocytopenia. Gastrointestinal toxicity was mild: nausea (10%), anorexia (15%) and no vomiting. Conclusions: This treatment has mild toxicity and good response rate. It may therefore be feasible before autologous bone marrow transplantation.
Databáze:	MEDLINE
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