title: A phase II study of V-BEAM as conditioning regimen before second auto-SCT for multiple myeloma.
abstract: High-dose melphalan has been the standard conditioning regimen for auto-SCT in multiple myeloma (MM) for decades. A more effective conditioning regimen may induce deeper responses and longer remission duration. It is especially needed in the setting of second auto-SCT, which rarely achieves comparable results with the first auto-SCT using the same conditioning regimen. Here we conducted a phase II study to investigate the efficacy and safety of a conditioning regimen V-BEAM (bortezomib-BEAM) before second auto-SCT for multiple myeloma. Ten patients were enrolled from September 2012 to May 2013. The CR rate at day +100 after auto-SCT was 75%; all except for one patient remained in remission after a median follow-up of 6 months. Three patients developed Clostridium difficile infection. Two patients died within the first 30 days of auto-SCT from neutropenic colitis and overwhelming sepsis, respectively. Due to the high rate of morbidity and mortality, the study was terminated after 10 patients. In summary, although the conditioning regimen V-BEAM before second auto-SCT for MM provided promising responses, it was associated with unexpected treatment-related toxicity and should not be investigated further without modifications.
authors: Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA.
authors: T-F
authors: TF
authors: Wang
authors: Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA.
authors: M A
authors: MA
authors: Fiala
authors: Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA.
authors: A F
authors: AF
authors: Cashen
authors: Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA.
authors: G L
authors: GL
authors: Uy
authors: Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA.
authors: C N
authors: CN
authors: Abboud
authors: Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA.
authors: T
authors: T
authors: Fletcher
authors: Division of Biostatistics, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA.
authors: N
authors: N
authors: Wu
authors: Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA.
authors: P
authors: P
authors: Westervelt
authors: Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA.
authors: J F
authors: JF
authors: DiPersio
authors: Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA.
authors: K E
authors: KE
authors: Stockerl-Goldstein
authors: Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA.
authors: R
authors: R
authors: Vij
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects; D064592:Autografts; D001897:Boronic Acids / Q000008:administration & dosage / Q000009:adverse effects; D000069286:Bortezomib; D002330:Carmustine / Q000008:administration & dosage / Q000009:adverse effects; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008558:Melphalan / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality / Q000628:therapy; D011034:Podophyllotoxin / Q000008:administration & dosage / Q000009:adverse effects; D011719:Pyrazines / Q000008:administration & dosage / Q000009:adverse effects; D033581:Stem Cell Transplantation; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods
chemical_list: D001897:Boronic Acids; D011719:Pyrazines; D003561:Cytarabine; D000069286:Bortezomib; D011034:Podophyllotoxin; D008558:Melphalan; D002330:Carmustine