Triple transplantation of autologous peripheral blood stem cells each time following conditioning with 100 mg/m2 of melphalan for multiple myeloma patients in poor performance status
| Autor: | Malgorzata Rokicka, Elżbieta Urbanowska, Monika Paluszewska, Jadwiga Dwilewicz-Trojaczek, Tigran Torosian, A Awedan, Wieslaw Wiktor-Jedrzejczak |
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| Rok vydání: | 2003 |
| Předmět: |
Adult
Melphalan medicine.medical_specialty Cyclophosphamide medicine.medical_treatment Immunoglobulins Hematopoietic stem cell transplantation Transplantation Autologous Dexamethasone Disease-Free Survival Antineoplastic Combined Chemotherapy Protocols Humans Medicine Antineoplastic Agents Alkylating Multiple myeloma Transplantation Chemotherapy Performance status business.industry Middle Aged medicine.disease Combined Modality Therapy Surgery Treatment Outcome Doxorubicin Vincristine Disease Progression Stem cell Multiple Myeloma business Stem Cell Transplantation medicine.drug |
| Zdroj: | Transplantation Proceedings. 35:2352-2354 |
| ISSN: | 0041-1345 |
| DOI: | 10.1016/s0041-1345(03)00816-9 |
| Popis: | Approximately one third of multiple myeloma patients (below 60 years) are diagnosed either in advanced disease or with significant comorbidities. Many other patients referred to transplant centers have already been heavily pretreated with multiple courses of various conventional chemotherapies. These patients are frequently in bad or even grave clinical condition; they are unlikely to survive standard high-dose melphalan (200 mg/m3) chemotherapy and autologous hematopoietic stem cell transplantation. Palumbo et al reported a protocol for elderly patients that utilized reduced conditioning (melphalan 100 mg/m2 three times at 2-month intervals, each time supported by autologous hematopoietic rescue). We have used this protocol as a start to develop a method to induce a remission in the aforementioned subgroup of myeloma patients. Patients with stage III disease and WHO performance status 2 or higher are treated with one or two cycles of cyclophosphamide (2 to 4 g/m2) and undergo peripheral blood stem cells collection. Subsequently, they are treated with three to four doses of melphalan (100 mg/m2) at 8- to 12-weeks intervals each time supported by infusion of peripheral blood stem cells. To date 13 patients have been entered into the protocol. With one exception of transiently stable disease, the remaining patients obtained at least partial remission and three, complete remission. The compliance was good and better with each subsequent course. For half of the patients the problem was a short duration of response. This method when developed may offer a new treatment alternative for a subgroup of high-risk multiple myeloma patients. |
| Databáze: | OpenAIRE |
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