title: Repeat administration of high dose melphalan in relapsed myeloma.
abstract: At a median time of 20 months following high dose melphalan for myeloma, 29 patients relapsed and were treated with induction chemotherapy to maximum response followed by a second course of high dose melphalan. The majority (90%) of patients received 200 mg m-2 with an autologous bone marrow transplant. Sixteen (55%) patients achieved complete remission and 11 (38%) a partial response. The median duration of remission was 17 (4-42) months. The median survival has not been reached, with 50% of patients alive at 58+ months after presentation. The period of neutropenia was similar during both first and second high dose procedures, but the duration of thrombocytopenia was longer in patients receiving melphalan for a second time (median 22 (16-56) days and 41 (18-69) days respectively). There was one treatment-related death due to thrombocytopenic haemorrhage. Repeated administration of high dose melphalan is a feasible approach for patients with relapsed myeloma.
authors.affiliation: CRC Section of Medicine, Institute of Cancer Research, Sutton, Surrey, UK.
authors.forename: J L
authors.initials: JL
authors.lastname: Mansi
authors.forename: D
authors.initials: D
authors.lastname: Cunningham
authors.forename: C
authors.initials: C
authors.lastname: Viner
authors.forename: E
authors.initials: E
authors.lastname: Ellis
authors.forename: M
authors.initials: M
authors.lastname: Meldrum
authors.forename: S
authors.initials: S
authors.lastname: Milan
authors.forename: M
authors.initials: M
authors.lastname: Gore
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008558:Melphalan / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000401:mortality; D012008:Recurrence; D015996:Survival Rate; D013997:Time Factors
chemical_list: D008558:Melphalan