Idarubicin containing regimen in multiple myeloma

Preliminary results of a pilot study using a modified "TANDEM" transplant program

G. Martinelli, A. Agazzi, D. Laszlo, P. Santoro, P. Mancuso, G. C. Pruneri, P. Greco, F. Bertolini

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Tandem autologous transplant actually represents a challenge in multiple myeloma treatment, but the best conditioning regimen is still under investigation. With the aim of evaluating the feasibility of a modified tandem transplant strategy, we treated 10 multiple myeloma patients after conventional first line chemotherapy with a two step conditioning regimen consisting of high-dose melphalan (200 mg/m2) followed by high-dose melphalan (180 mg/m2) together with indarubicin (15 mg/sqm2 c.i. × 3 days) both with peripheral stem cell support. At first transplant, the median age was 62 years, performance status was good and disease status was CR in 2 patients and PR in the rest. At the end of the first transplant, 70% of patients achieved CR and only mild toxicity was observed. After the second transplant further improvement of the response rate was obtained with 90% CR. However, we observed three toxic early infection-related deaths from CMV and legionella pneumonia at day + 17, +26, +54 after transplantation. Although this schedule seems to be effective in terms of response rate, the 30% TRM imposes an anthracycline dose-reduction with careful patient selection. This approach could reduce the toxic effects and maintain the efficacy of therapy at the same time.

Original languageEnglish
Pages (from-to)299-302
Number of pages4
JournalLeukemia and Lymphoma
Volume44
Issue number2
DOIs
Publication statusPublished - Feb 1 2003

Fingerprint

Idarubicin
Multiple Myeloma
Transplants
Melphalan
Poisons
Legionella
Anthracyclines
Autografts
Patient Selection
Pneumonia
Appointments and Schedules
Transplantation
Drug Therapy
Therapeutics
Infection

Keywords

  • Idarubicin
  • Melphalan
  • Multiple myeloma
  • Tandem autologous transplant

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

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title = "Idarubicin containing regimen in multiple myeloma: Preliminary results of a pilot study using a modified {"}TANDEM{"} transplant program",
abstract = "Tandem autologous transplant actually represents a challenge in multiple myeloma treatment, but the best conditioning regimen is still under investigation. With the aim of evaluating the feasibility of a modified tandem transplant strategy, we treated 10 multiple myeloma patients after conventional first line chemotherapy with a two step conditioning regimen consisting of high-dose melphalan (200 mg/m2) followed by high-dose melphalan (180 mg/m2) together with indarubicin (15 mg/sqm2 c.i. × 3 days) both with peripheral stem cell support. At first transplant, the median age was 62 years, performance status was good and disease status was CR in 2 patients and PR in the rest. At the end of the first transplant, 70{\%} of patients achieved CR and only mild toxicity was observed. After the second transplant further improvement of the response rate was obtained with 90{\%} CR. However, we observed three toxic early infection-related deaths from CMV and legionella pneumonia at day + 17, +26, +54 after transplantation. Although this schedule seems to be effective in terms of response rate, the 30{\%} TRM imposes an anthracycline dose-reduction with careful patient selection. This approach could reduce the toxic effects and maintain the efficacy of therapy at the same time.",
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AU - Agazzi, A.

AU - Laszlo, D.

AU - Santoro, P.

AU - Mancuso, P.

AU - Pruneri, G. C.

AU - Greco, P.

AU - Bertolini, F.

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