title: Liposomal daunorubicin and dexamethasone as a treatment for multiple myeloma--the DD Protocol.
abstract: OBJECTIVE
  Liposomal daunorubicin has been used to treat hematological malignancies, including multiple myeloma (MM). The goal was to evaluate efficacy, side-effects and toxicity of liposomal daunorubicin and dexamethasone ("DD Protocol").
  
  
  METHODS
  Prospective study at Sírio-Libanês, São Camilo, Brasil and Alemão Oswaldo Cruz hospitals.
  
  
  METHODS
  Twenty consecutive patients with active MM received four cycles of liposomal daunorubicin intravenously for two hours (25-30 mg/m(2)/day) on three consecutive days per month, with oral dexamethasone (10 mg every six hours) on four consecutive days three times a month.
  
  
  RESULTS
  The male/female ratio was 1:1 and median age 60. Nine patients were stage IIA, ten IIIA and one IIIB. The median from diagnosis to starting DD was 13 months. All patients received four cycles, except one. Fifteen had already received chemotherapy before DD. Responses of > 50% reduction in serum monoclonal paraprotein were observed in six patients after first cycle (30%), six after second (30%) and four after third (20%), while four (20%) did not obtain this. Initially, 17 patients (85%) had anemia: 12 (70%) achieved correction. Progressive disease was observed in three patients (15%), while one had minimal response, four (20%) partial and 12 (60%) complete. Hematological toxicity was acceptable: three patients (15%) had neutrophils < 1,000/mm(3); none had thrombocytopenia. Gastrointestinal toxicity was mild: nausea (10%), anorexia (15%) and no vomiting.
  
  
  CONCLUSIONS
  This treatment has mild toxicity and good response rate. It may therefore be feasible before autologous bone marrow transplantation.
authors.affiliation: Hospital Sírio-Libanês, São Paulo, Brazil. fldulley@usp.br
authors.forename: Frederico Luiz
authors.initials: FL
authors.lastname: Dulley
authors.forename: Rosaura
authors.initials: R
authors.lastname: Saboya
authors.forename: Vânia Tietsche de Moraes
authors.initials: VT
authors.lastname: Hungria
authors.forename: Nadjanara Dorna
authors.initials: ND
authors.lastname: Bueno
authors.forename: Fernando Gomes de
authors.initials: FG
authors.lastname: Mello
authors.forename: Maria Tereza
authors.initials: MT
authors.lastname: Frota
authors.forename: Carlos Sergio
authors.initials: CS
authors.lastname: Chiattone
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Barros
authors.forename: Nair Sumie
authors.initials: NS
authors.lastname: Mori
authors.forename: Daniel
authors.initials: D
authors.lastname: Sturaro
authors.forename: Maria Cristina Martins de Almeida
authors.initials: MC
authors.lastname: Macedo
authors.forename: Roberto Luiz da
authors.initials: RL
authors.lastname: Silva
authors.forename: Leila Maria Magalhães Pessoa de
authors.initials: LM
authors.lastname: Melo
authors.forename: Cármino Antonio
authors.initials: CA
authors.lastname: Souza
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D003630:Daunorubicin / Q000008:administration & dosage / Q000009:adverse effects; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008081:Liposomes; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000473:pathology; D010266:Paraproteins / Q000032:analysis; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D008081:Liposomes; D010266:Paraproteins; D003907:Dexamethasone; D003630:Daunorubicin