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High-dose BCNU/Melphalan conditioning regimen before autologous stem cell transplantation in newly diagnosed multiple myeloma.

Publication ,  Journal Article
Sivaraj, D; Bacon, W; Long, GD; Rizzieri, DA; Horwitz, ME; Sullivan, KM; Kang, Y; Li, Z; Chao, NJ; Gasparetto, C
Published in: Bone Marrow Transplant
January 2018

Single-agent high-dose melphalan (HDM, 200 mg/m2) has been the most commonly used conditioning regimen prior to autologous stem cell transplant, since its introduction in 1992. We used a more aggressive alkylator-based conditioning regimen in an attempt to overcome early relapse and combat drug resistance. We present a retrospective comparison and long-term follow-up of newly diagnosed patients with multiple myeloma (MM) treated with induction followed by either high-dose carmustine (BCNU) and HDM, or HDM alone, both followed by autologous stem cell transplant (ASCT). Between 1997 and 2002, 104 patients were treated with BCNU/HDM; from 2001 to 2008, 103 patients were treated with HDM alone. Median follow-up of survivors was 78 and 68 months for the BCNU/HDM and HDM groups, respectively. The median PFS was significantly increased with the BCNU/HDM regimen (40.4 vs 20.5 months, P<0.001). Median overall survival was increased with the BCNU/HDM regimen when compared with HDM alone (88.4 vs 67.2 months, P=0.07), but the difference was not statistically significant. Transplant-related mortality was similar in both groups (2.9% with BCNU and HDM vs 3.9% with HDM alone). Our findings suggest that the BCNU/HDM preparative regimen should be investigated further and potentially compared in a prospective randomized manner with HDM alone.

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Published In

Bone Marrow Transplant

DOI

EISSN

1476-5365

Publication Date

January 2018

Volume

53

Issue

1

Start / End Page

34 / 38

Location

England

Related Subject Headings

  • Transplantation, Autologous
  • Transplantation Conditioning
  • Retrospective Studies
  • Multiple Myeloma
  • Middle Aged
  • Melphalan
  • Male
  • Immunology
  • Humans
  • Hematopoietic Stem Cell Transplantation
 

Citation

APA
Chicago
ICMJE
MLA
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Sivaraj, D., Bacon, W., Long, G. D., Rizzieri, D. A., Horwitz, M. E., Sullivan, K. M., … Gasparetto, C. (2018). High-dose BCNU/Melphalan conditioning regimen before autologous stem cell transplantation in newly diagnosed multiple myeloma. Bone Marrow Transplant, 53(1), 34–38. https://doi.org/10.1038/bmt.2017.208
Sivaraj, D., W. Bacon, G. D. Long, D. A. Rizzieri, M. E. Horwitz, K. M. Sullivan, Y. Kang, Z. Li, N. J. Chao, and C. Gasparetto. “High-dose BCNU/Melphalan conditioning regimen before autologous stem cell transplantation in newly diagnosed multiple myeloma.Bone Marrow Transplant 53, no. 1 (January 2018): 34–38. https://doi.org/10.1038/bmt.2017.208.
Sivaraj D, Bacon W, Long GD, Rizzieri DA, Horwitz ME, Sullivan KM, et al. High-dose BCNU/Melphalan conditioning regimen before autologous stem cell transplantation in newly diagnosed multiple myeloma. Bone Marrow Transplant. 2018 Jan;53(1):34–8.
Sivaraj, D., et al. “High-dose BCNU/Melphalan conditioning regimen before autologous stem cell transplantation in newly diagnosed multiple myeloma.Bone Marrow Transplant, vol. 53, no. 1, Jan. 2018, pp. 34–38. Pubmed, doi:10.1038/bmt.2017.208.
Sivaraj D, Bacon W, Long GD, Rizzieri DA, Horwitz ME, Sullivan KM, Kang Y, Li Z, Chao NJ, Gasparetto C. High-dose BCNU/Melphalan conditioning regimen before autologous stem cell transplantation in newly diagnosed multiple myeloma. Bone Marrow Transplant. 2018 Jan;53(1):34–38.

Published In

Bone Marrow Transplant

DOI

EISSN

1476-5365

Publication Date

January 2018

Volume

53

Issue

1

Start / End Page

34 / 38

Location

England

Related Subject Headings

  • Transplantation, Autologous
  • Transplantation Conditioning
  • Retrospective Studies
  • Multiple Myeloma
  • Middle Aged
  • Melphalan
  • Male
  • Immunology
  • Humans
  • Hematopoietic Stem Cell Transplantation