title: Fifty years of melphalan use in hematopoietic stem cell transplantation.
abstract: Melphalan remains the most widely used agent in preparative regimens for hematopoietic stem cell transplantation (SCT). From its initial discovery more than 50 years ago, it has been gradually incorporated in the conditioning regimens for both autologous and allogeneic transplantations because of its myeloablative properties and broad antitumor effects as a DNA alkylating agent. Melphalan remains the mainstay conditioning for multiple myeloma and lymphomas, and it has been used successfully in preparative regimens of a variety of other hematological and nonhematological malignancies. The addition of newer agents to conditioning, such as bortezomib or lenalidomide for myeloma or clofarabine for myeloid malignancies, may improve antitumor effects for transplantation, whereas melphalan in combination with alemtuzumab may represent a backbone for future cellular therapy because of reliable engraftment and low toxicity profile. This review summarizes the development and the current use of this remarkable drug in hematopoietic SCT.
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
authors.forename: Ulas D
authors.initials: UD
authors.lastname: Bayraktar
authors.forename: Qaiser
authors.initials: Q
authors.lastname: Bashir
authors.forename: Muzaffar
authors.initials: M
authors.lastname: Qazilbash
authors.forename: Richard E
authors.initials: RE
authors.lastname: Champlin
authors.forename: Stefan O
authors.initials: SO
authors.lastname: Ciurea
mesh_terms: D000227:Adenine Nucleotides / Q000008:administration & dosage; D000074323:Alemtuzumab; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols; D001087:Arabinonucleosides / Q000008:administration & dosage; D001897:Boronic Acids / Q000008:administration & dosage; D000069286:Bortezomib; D000077866:Clofarabine; D006085:Graft Survival / Q000187:drug effects / Q000276:immunology; D019337:Hematologic Neoplasms / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D000077269:Lenalidomide; D008558:Melphalan / Q000494:pharmacology / Q000627:therapeutic use*; D009101:Multiple Myeloma / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D019653:Myeloablative Agonists / Q000494:pharmacology / Q000627:therapeutic use*; D011719:Pyrazines / Q000008:administration & dosage; D013792:Thalidomide / Q000008:administration & dosage / Q000031:analogs & derivatives; D019172:Transplantation Conditioning / Q000379:methods*; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous
chemical_list: D000227:Adenine Nucleotides; D061067:Antibodies, Monoclonal, Humanized; D001087:Arabinonucleosides; D001897:Boronic Acids; D019653:Myeloablative Agonists; D011719:Pyrazines; D000074323:Alemtuzumab; D013792:Thalidomide; D000069286:Bortezomib; D000077866:Clofarabine; D000077269:Lenalidomide; D008558:Melphalan