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Post-Transplant Complications

Amifostine reduces mucosal damage after high-dose melphalan conditioning and autologous peripheral blood progenitor cell transplantation for patients with multiple myeloma

Bone Marrow Transplantation volume 30, pages 769–775 (2002)Cite this article

Abstract

High-dose melphalan (HDM) has been adopted as standard therapy in the treatment of multiple myeloma. This treatment is associated with non-selective cytotoxicity, causing oral mucositis as the major non-hematological side-effect. Amifostine is a cytoprotector which prevents toxicity induced by anticancer therapy. We prospectively compared two groups of patients who either received (group A, n = 21) or did not receive (group B, n = 20) amifostine (740 mg/m2) before HDM (200 mg/m2) followed by autologous peripheral blood progenitor cell transplantation. The occurrence of severe oral mucositis was significantly decreased in group A in comparison to group B (33% vs 65%, P < 0.05). Six patients in group A required opioid analgesic therapy during a mean period of 4.8 days as compared to eight patients for 6.5 days in group B (P = NS). Delayed vomiting was less frequent in group A (43% vs 70%, P = 0.07) and significantly less severe in group A (grade 2–4) vomiting: two patients vs nine patients, P < 0.02). No difference was observed between the two groups in either hematological toxicity after HDM or in response rate. Grade I emesis was the only immediate side-effect observed after amifostine administration. We conclude that amifostine can reduce mucositis induced by HDM.

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Acknowledgements

We wish to thank Joelle Réglioni for the technical assistance provided in this study, and Schering-Plough France for supplying amifostine.

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Authors and Affiliations

  1. Haematology Department, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France

    C Thieblemont, C Dumontet, H Saad, N Roch, F Bouafia, P Arnaud, O Hequet, D Espinouse, G Salles & B Coiffier

  2. Unité de Biostatistique, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France

    P Roy

  3. Etablissement de Transfusion Sanguine, Hôpital E Herriot, Lyon, France

    A Eljaafari-Corbin

  4. Schering-Plough, Levallois-Perret, France

    C du Manoir-Baumgarten

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  1. C Thieblemont
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Thieblemont, C., Dumontet, C., Saad, H. et al. Amifostine reduces mucosal damage after high-dose melphalan conditioning and autologous peripheral blood progenitor cell transplantation for patients with multiple myeloma. Bone Marrow Transplant 30, 769–775 (2002). https://doi.org/10.1038/sj.bmt.1703757

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