High-dose busulfan in patients with myeloma.
OBJECTIVE
To evaluate the use of high-dose busulfan (HDB) with autologous bone marrow transplantation (ABMT) in patients with myeloma.


METHODS
Fifteen patients received HDB (16 mg/kg), eight of whom received high-dose melphalan (HDM) but had experienced a short remission or progression-free interval. Two patients had received HDM on two previous occasions, one had no response to low-dose melphalan, and four had impaired renal function (edathamil clearance < 40 mL/min). All patients received induction chemotherapy before HDB.


RESULTS
Two patients were in complete remission (CR) after induction chemotherapy before HDB. Of the remaining 13 patients, four (31%) achieved CR and two (15%) achieved a partial remission for an overall response rate of 46%. There were three treatment-related deaths, but the toxicity was otherwise predictable and manageable.


CONCLUSIONS
In heavily pretreated patients, HDB results in a relatively high response rate. It can also be used safely in patients with renal impairment who are not suitable for HDM.
Mansi
J
J
Cancer Research Campaign Section of Medicine, Royal Marsden Hospital, Sutton, Surrey, United Kingdom.
da Costa
F
F
Viner
C
C
Judson
I
I
Gore
M
M
Cunningham
D
D
D000328:Adult; D016026:Bone Marrow Transplantation; D002066:Busulfan / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003404:Creatinine / Q000097:blood; D005260:Female; D006402:Hematologic Diseases / Q000139:chemically induced; D006801:Humans; D008297:Male; D008558:Melphalan / Q000627:therapeutic use; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood / Q000188:drug therapy* / Q000601:surgery; D010865:Pilot Projects; D012074:Remission Induction; D014182:Transplantation, Autologous
D003404:Creatinine; D002066:Busulfan; D008558:Melphalan