OPP-EBV-CAD regimen as salvage treatment in advanced refractory or resistant multiple myeloma

M. Colombi, A. Guffanti, A. Alietti, M. L. Latargia, C. Vener, A. T. Maiolo, L. Baldini

Research output: Contribution to journalArticle

Abstract

With the aim of developing an effective therapy for heavily pretreated refractory MM outpatients, we evaluated the OPPEBVCAD regimen, a Hodgkin's disease-derived protocol that includes many drugs effective in MM administered in a sequential schedule. Twenty-two pts aged 42-72 years, with symptomatic highly-pretreated refractory (18 cases), or primary resistant MM (four cases, including two pts with plasma cell leukemia-PCL) received this therapy every 28 days (2-4 cycles, followed by a maintenance program). Therapeutic response (Chronic Leukemia-Myeloma Task Force criteria) and performance status (PS) and pain (W.H.O.) were evaluated. All of the pts were evaluable for response. There were 9 (40%) objective responses (OR: stabilization of blood counts and bone lesions, serum calcium normalization, 50% or more reduction in the concentration of serum monoclonal component (MC), 90% reduction in Bence-Jones proteinuria), 8 (36%) partial responses (PR: 25-50% reduction in serum MC), 1 no response or stable disease (NR), and 4 (18%) cases of progressive disease (PD). OR plus PR were 77%. Of the 4 primary resistant tumors (2 PCL and 2 MM), 2 achieved PR, 1 OR (a PCL case) and 1 progressed. Median survival was 15 months for responding pts (OR plus PR) and 4.5 months for non-responders (NR plus PD). PS and pain improved in 15 pts and did not change in 9. The most frequent side effects were cytopenias, with one drug related infective death. The OPPEBVCAD regimen proved to be an effective therapy for refractory relapsing or primary resistant MM: in responders (two-thirds of the pts), survival was prolonged by about 10 months. Its efficacy in anthracycline-treated pts, as well as the feasibility of using it on an outpatient basis without any continuous drug infusions, make this regimen a promising third line salvage therapy.

Original languageEnglish
Pages (from-to)87-94
Number of pages8
JournalLeukemia and Lymphoma
Volume40
Issue number1-2
Publication statusPublished - 2001

Keywords

  • OPPEBVCAD regimen
  • Plasma-cell leukemia
  • Primary resistant multiple myeoloma
  • Refractory heavily treated multiple myeloma
  • Survival of responding vs non-responding cases

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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  • Cite this

    Colombi, M., Guffanti, A., Alietti, A., Latargia, M. L., Vener, C., Maiolo, A. T., & Baldini, L. (2001). OPP-EBV-CAD regimen as salvage treatment in advanced refractory or resistant multiple myeloma. Leukemia and Lymphoma, 40(1-2), 87-94.