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Chonnam Med J. 2019 Jan;55(1):25-30. doi: 10.4068/cmj.2019.55.1.25. Epub 2019 Jan 25.

Efficacy and Safety of Melphalan, Cyclophosphamide and Dexamethasone (MCD) as a Salvage Treatment for Patients with Relapsed/Refractory Multiple Myeloma.

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1
Department of Hematology-Oncology, Wonkwang University Hospital, Iksan, Korea.
2
Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Hwasun, Korea.

Abstract

This study investigated the efficacy and safety of melphalan, cyclophosphamide, and dexamethasone (MCD) as a salvage regimen for heavily treated relapsed or refractory multiple myeloma patients. We retrospectively analyzed a total of 27 patients who received the MCD regimen between April 2011 and November 2013. The MCD regimen consisted of oral melphalan 6.75 mg/m2 on days 1-4, once-weekly dose of oral cyclophosphamide 300 mg/m2 and dexamethasone 20 mg/m2 on days 1-4 and days 15-18. Each cycle was repeated every 28 days. The median age of the patients was 66 years and the MCD regimen was initiated at a median 37.7 months from diagnosis. Patients received a median of five regimens including autologous stem cell transplantation. The overall response rate was 25.9% (very good partial response 3.7%, partial response 22.2%) and 8 (29.6%) patients achieved a minor response. Median progression-free survival was 5.6 months (95% confidence interval [CI], 4.2-8.5) ; overall survival 11.7 months (95% CI, 5.4-16.6). Grade 3 or 4 neutropenia and thrombocytopenia were observed in 51.8% and 33.3%, respectively. Although the overall response rate is relatively low, the MCD regimen may have a role as a bridge to a novel regimen in heavily pretreated patients with MM.

KEYWORDS:

Cyclophosphamide; Melphalan; Multiple Myeloma; Salvage Therapy

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