The combination of cyclophosphomide, thalidomide and dexamethasone is an effective alternative to cyclophosphamide - vincristine - doxorubicin - methylprednisolone as induction chemotherapy prior to autologous transplantation for multiple myeloma: a case-matched analysis.
A retrospective case-matched study was conducted to compare the oral regimen CTD (cyclophosphamide - thalidomide - dexamethasone) and infusional CVAMP (cyclophosphamide - vincristine - doxorubicin - methylprednisolone) as induction therapy followed by autologous peripheral blood stem-cell transplantation (PBSCT) for newly diagnosed multiple myeloma patients. The response rate after three cycles of treatment was statistically higher with CTD (n = 27) compared to CVAMP (n = 27) (89% vs. 56%, P = 0.016). Toxicity studies showed more neutropenia (grade 3/4) (4% vs. 60%, P = 0.0002) with CVAMP and more thrombotic episodes with CTD (11% vs. 4%). CTD may emerge as the superior induction regimen prior to PBSCT, in terms of high efficacy and better tolerability.
Wu
Ping
P
Haemato-Oncology Unit, Royal Marsden Hosptial, Sutton, Surrey, UK.
Davies
Faith E
FE
Horton
Clive
C
Jenner
Matthew W
MW
Krishnan
Biju
B
Alvares
Caroline L
CL
Saso
Radovan
R
McCormack
Rita
R
Dines
Sharon
S
Treleaven
Jennifer G
JG
Potter
Michael N
MN
Ethell
Mark E
ME
Morgan
Gareth J
GJ
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016022:Case-Control Studies; D003520:Cyclophosphamide / Q000009:adverse effects / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D004317:Doxorubicin / Q000009:adverse effects / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000009:adverse effects / Q000627:therapeutic use; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D036102:Peripheral Blood Stem Cell Transplantation; D013792:Thalidomide / Q000627:therapeutic use; D014182:Transplantation, Autologous; D014750:Vincristine / Q000009:adverse effects / Q000627:therapeutic use
D000970:Antineoplastic Agents; D013792:Thalidomide; D014750:Vincristine; D003907:Dexamethasone; D004317:Doxorubicin; D003520:Cyclophosphamide; D008775:Methylprednisolone