title: High dose cyclophosphamide, BCNU and VP-16 with autologous blood stem cell support for refractory multiple myeloma.
abstract: Eleven patients with advanced multiple myeloma refractory to standard doses of alkylating agents and salvage therapy with vincristine, adriamycin and dexamethasone (VAD) were treated with high dose cyclophosphamide, BCNU and VP-16 (CBV) with autologous blood stem cell support. Seven patients had marked marrow plasmacytosis (greater than 30%) and four had extensive pelvic bone disease precluding autologous marrow harvest. Four patients responded with a median remission duration of 7 months. Recovery of granulocytes and platelets occurred promptly in 10 evaluable patients with complete hematologic recovery. Autologous blood stem cells can provide safe and effective support for high dose CBV treatment of myeloma patients with extensive marrow plasmacytosis. The short remissions call for better cytoreductive regimens with consideration for earlier use when the myeloma may be more responsive to therapy.
authors.affiliation: Department of Hematology, University of Texas M.D. Anderson Cancer Center, Houston.
authors.forename: G J
authors.initials: GJ
authors.lastname: Ventura
authors.forename: B
authors.initials: B
authors.lastname: Barlogie
authors.forename: J P
authors.initials: JP
authors.lastname: Hester
authors.forename: J C
authors.initials: JC
authors.lastname: Yau
authors.forename: C F
authors.initials: CF
authors.lastname: LeMaistre
authors.forename: R O
authors.initials: RO
authors.lastname: Wallerstein
authors.forename: J A
authors.initials: JA
authors.lastname: Spinolo
authors.forename: K A
authors.initials: KA
authors.lastname: Dicke
authors.forename: L H
authors.initials: LH
authors.lastname: Horwitz
authors.forename: R
authors.initials: R
authors.lastname: Alexanian
mesh_terms: D001804:Blood Transfusion, Autologous; D016026:Bone Marrow Transplantation / Q000473:pathology / Q000502:physiology; D002330:Carmustine / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005047:Etoposide / Q000627:therapeutic use*; D006410:Hematopoiesis / Q000502:physiology; D018380:Hematopoietic Stem Cell Transplantation; D006412:Hematopoietic Stem Cells / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D014182:Transplantation, Autologous / Q000502:physiology
chemical_list: D005047:Etoposide; D003520:Cyclophosphamide; D002330:Carmustine