title: 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.
abstract: 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.
authors.affiliation: Haemato-Oncology Unit, Royal Marsden Hosptial, Sutton, Surrey, UK.
authors.forename: Ping
authors.initials: P
authors.lastname: Wu
authors.forename: Faith E
authors.initials: FE
authors.lastname: Davies
authors.forename: Clive
authors.initials: C
authors.lastname: Horton
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Jenner
authors.forename: Biju
authors.initials: B
authors.lastname: Krishnan
authors.forename: Caroline L
authors.initials: CL
authors.lastname: Alvares
authors.forename: Radovan
authors.initials: R
authors.lastname: Saso
authors.forename: Rita
authors.initials: R
authors.lastname: McCormack
authors.forename: Sharon
authors.initials: S
authors.lastname: Dines
authors.forename: Jennifer G
authors.initials: JG
authors.lastname: Treleaven
authors.forename: Michael N
authors.initials: MN
authors.lastname: Potter
authors.forename: Mark E
authors.initials: ME
authors.lastname: Ethell
authors.forename: Gareth J
authors.initials: GJ
authors.lastname: Morgan
mesh_terms: 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
chemical_list: D000970:Antineoplastic Agents; D013792:Thalidomide; D014750:Vincristine; D003907:Dexamethasone; D004317:Doxorubicin; D003520:Cyclophosphamide; D008775:Methylprednisolone