Muthu Veeraputhiran1, Tania Jain2, Abhinav Deol3, Lois Ayash3, Seongho Kim4, Gregory Dyson4, Divaya Bhutani3, Lawrence G Lum5, Voravit Ratanatharathorn3, Joseph P Uberti3, Muneer H Abidi3. 1. Department of Oncology, Wayne State University, Detroit, MI. Electronic address: mkumaran.2006@gmail.com. 2. Department of Internal Medicine, Wayne State University, Detroit, MI. 3. Department of Oncology, Wayne State University, Detroit, MI; Department of Internal Medicine, Wayne State University, Detroit, MI; Blood and Marrow Stem Cell Transplant Program, Wayne State University, Detroit, MI. 4. Biostatistics Core, Karmanos Cancer Institute, Wayne State University, Detroit, MI. 5. Department of Oncology, Wayne State University, Detroit, MI; Department of Internal Medicine, Wayne State University, Detroit, MI; Blood and Marrow Stem Cell Transplant Program, Wayne State University, Detroit, MI; Department of Immunology and Microbiology, Karmanos Cancer Institute, Wayne State University, Detroit, MI.
Abstract
BACKGROUND: Salvage autologous stem cell transplantation (ASCT) is increasingly used for eligible patients with multiple myeloma (MM) for progress after conventional chemotherapy. We recently used BEAM (BCNU, etoposide, cytarabine, and melphalan) conditioning for patients with myeloma receiving salvage ASCT whose disease progressed after a first ASCT with high-dose melphalan (HDM). We report safety and efficacy of BEAM salvage ASCT in MM in comparison with HDM-based salvage ASCT. PATIENTS AND METHODS: Between 2008 and 2013, 43 consecutive patients received salvage ASCT for MM (19 with HDM; 24 with BEAM). RESULTS: The BEAM group had a higher incidence of infections, intensive level of care, and fever (19 vs. 13 patients; P = .02), whereas the melphalan group had a higher incidence of mucositis (7 vs. 2 patients; P = .03). Other toxicities were not different. There was no significant difference in disease status and response rate before and after salvage ASCT between the 2 groups. The median time of follow-up after salvage ASCT was 5 and 9 months and the median progression-free survival (PFS) times were 7.7 and 12.1 months (P = .82) for BEAM and melphalan, respectively. CONCLUSION: BEAM seemed to be associated with higher toxicity with comparable efficacy to HDM ASCT. Longer follow-up is needed to determine whether there is any significant difference in PFS between the 2 groups.
BACKGROUND: Salvage autologous stem cell transplantation (ASCT) is increasingly used for eligible patients with multiple myeloma (MM) for progress after conventional chemotherapy. We recently used BEAM (BCNU, etoposide, cytarabine, and melphalan) conditioning for patients with myeloma receiving salvage ASCT whose disease progressed after a first ASCT with high-dose melphalan (HDM). We report safety and efficacy of BEAM salvage ASCT in MM in comparison with HDM-based salvage ASCT. PATIENTS AND METHODS: Between 2008 and 2013, 43 consecutive patients received salvage ASCT for MM (19 with HDM; 24 with BEAM). RESULTS: The BEAM group had a higher incidence of infections, intensive level of care, and fever (19 vs. 13 patients; P = .02), whereas the melphalan group had a higher incidence of mucositis (7 vs. 2 patients; P = .03). Other toxicities were not different. There was no significant difference in disease status and response rate before and after salvage ASCT between the 2 groups. The median time of follow-up after salvage ASCT was 5 and 9 months and the median progression-free survival (PFS) times were 7.7 and 12.1 months (P = .82) for BEAM and melphalan, respectively. CONCLUSION: BEAM seemed to be associated with higher toxicity with comparable efficacy to HDM ASCT. Longer follow-up is needed to determine whether there is any significant difference in PFS between the 2 groups.
Authors: Dipenkumar Modi; Hyejeong Jang; Seongho Kim; Malini Surapaneni; Kamya Sankar; Abhinav Deol; Lois Ayash; Divaya Bhutani; Lawrence G Lum; Voravit Ratanatharathorn; Richard Manasa; Kendra Mellert; Pranatharthi Chandrasekar; Joseph P Uberti Journal: Support Care Cancer Date: 2017-04-02 Impact factor: 3.603
Authors: Maximilian Christopeit; Martin Schmidt-Hieber; Rosanne Sprute; Oliver A Cornely; Georg Maschmeyer; Dieter Buchheidt; Marcus Hentrich; Meinolf Karthaus; Olaf Penack; Markus Ruhnke; Florian Weissinger Journal: Ann Hematol Date: 2020-10-20 Impact factor: 3.673