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

Antonio Palumbo, Ilaria Avonto, Benedetto Bruno, Antonietta Falcone, Potito Rosario Scalzulli, Maria Teresa Ambrosini, Sara Bringhen, Francesa Gay, Federica Cavallo, Patrizia Falco, Massimo Massaia, Pellegrino Musto, Mario Boccadoro

Research output: Contribution to journalArticlepeer-review

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/m2 and bortezomib 1.3 mg/m2 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 neutrope nia, 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/dexamethas one showed encouraging antimyeloma activity in patients with advanced-stage myeloma.

Original languageEnglish
Pages (from-to)475-477
Number of pages3
JournalClinical Lymphoma and Myeloma
Volume6
Issue number6
DOIs
Publication statusPublished - May 2006

Keywords

  • Febrile neutropenia
  • Peripheral neuropathy
  • Pneumonia
  • Prednisone
  • Stem cell transplantation

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Hematology

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