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Clin Lymphoma Myeloma. 2006 May;6(6):475-7.

Intermediate-dose melphalan (100 mg/m2)/bortezomib/thalidomide/dexamethasone and stem cell support in patients with refractory or relapsed myeloma.

Author information

1
Divisione di Ematologia dell'Universita di Torino, Azienda Ospedaliera S. Giovanni Battista, Ospedale Molinette, Italy. appalumbo@yahoo.com

Abstract

BACKGROUND:

Bortezomib and thalidomide have shown synergy with melphalan and dexamethasone. We used this 4-drug combination as conditioning before autologous hematopoietic cell infusions.

PATIENTS AND METHODS:

Twenty-six patients with advanced-stage myeloma were treated with melphalan 50 mg/m(2) and bortezomib 1.3 mg/m(2) on days -6 and -3 in association with thalidomide 200 mg and dexamethasone 20 mg on days -6 through -3, followed by hematopoietic cell support on day 0.

RESULTS:

Nonhematologic toxicities included pneumonia, febrile neutropenia, and peripheral neuropathy. All patients had undergone autologous transplantation at diagnosis, and 13 patients (50%) underwent an additional transplantation at relapse. Responses occurred in 17 of 26 patients (65%), including 1 complete remission, 3 near complete remissions (12%), and 2 very good partial remissions (8%). Response rate was higher than that induced by the previous line of treatment in 12 patients (46%).

CONCLUSION:

Melphalan/bortezomib/thalidomide/dexamethasone showed encouraging antimyeloma activity in patients with advanced-stage myeloma.

PMID:
16796778
DOI:
10.3816/CLM.2006.n.028
[Indexed for MEDLINE]

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