High-dose idarubicin, busulphan and melphalan for autologous stem cell transplantation in multiple myeloma responsive to DAV chemotherapy: comparison with a historical control.
Since 1997, 32 newly diagnosed multiple myeloma patients responsive to DAV chemotherapy were autografted with idarubicin-intensified busulphan-melphalan (ida-bu-mel). Main endpoints of the study were transplant-related toxicity, overall survival (OS) and progression-free survival (PFS). The results were compared with a historical control group of 38 patients treated with the 'standard' bu-mel regimen. Concerning time to engraftment, no significant difference was observed between the two groups, while toxicity was significantly higher in the intensive conditioning group, regarding grade IV mucositis, duration of profound neutropenia, incidence of infections and platelet requirement. Five-year OS and PFS are 73 versus 78% and 37 versus 48% for the intensive and standard regimen, respectively (p value not significant). The ida-bu-mel schedule appears to be a feasible and effective regimen for newly diagnosed multiple myeloma patients; nevertheless, no apparent benefit in OS and PFS arises from the comparison with a historical control treated with standard bu-mel, which is better tolerated and at least equally effective.
Capria
Saveria
S
Dipartimento di Biotecnologie Cellulari ed Ematologia, Università La Sapienza, Rome, Italy.
Petrucci
Maria Teresa
MT
Pulsoni
Alessandro
A
Ribersani
Michela
M
Baldacci
Erminia
E
de Propris
Maria Stefania
MS
Meloni
Giovanna
G
D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002066:Busulfan / Q000008:administration & dosage; D003606:Dacarbazine / Q000008:administration & dosage; D005260:Female; D006085:Graft Survival / Q000187:drug effects; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage; D007239:Infections / Q000209:etiology / Q000401:mortality / Q000628:therapy; D008297:Male; D008558:Melphalan / Q000008:administration & dosage; D008875:Middle Aged; D052016:Mucositis / Q000209:etiology / Q000401:mortality / Q000628:therapy; D009101:Multiple Myeloma / Q000150:complications / Q000401:mortality / Q000628:therapy*; D009503:Neutropenia / Q000209:etiology / Q000401:mortality / Q000628:therapy; D015376:Nimustine / Q000008:administration & dosage; D036102:Peripheral Blood Stem Cell Transplantation; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous; D014750:Vincristine / Q000008:administration & dosage
D000903:Antibiotics, Antineoplastic; D018906:Antineoplastic Agents, Alkylating; D015376:Nimustine; D014750:Vincristine; D003606:Dacarbazine; D002066:Busulfan; D008558:Melphalan; D015255:Idarubicin