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Plasma Cell Disorders

A phase II study of V-BEAM as conditioning regimen before second auto-SCT for multiple myeloma

Bone Marrow Transplantation volume 49, pages 1366–1370 (2014)Cite this article

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Abstract

High-dose melphalan has been the standard conditioning regimen for auto-SCT in multiple myeloma (MM) for decades. A more effective conditioning regimen may induce deeper responses and longer remission duration. It is especially needed in the setting of second auto-SCT, which rarely achieves comparable results with the first auto-SCT using the same conditioning regimen. Here we conducted a phase II study to investigate the efficacy and safety of a conditioning regimen V-BEAM (bortezomib-BEAM) before second auto-SCT for multiple myeloma. Ten patients were enrolled from September 2012 to May 2013. The CR rate at day +100 after auto-SCT was 75%; all except for one patient remained in remission after a median follow-up of 6 months. Three patients developed Clostridium difficile infection. Two patients died within the first 30 days of auto-SCT from neutropenic colitis and overwhelming sepsis, respectively. Due to the high rate of morbidity and mortality, the study was terminated after 10 patients. In summary, although the conditioning regimen V-BEAM before second auto-SCT for MM provided promising responses, it was associated with unexpected treatment-related toxicity and should not be investigated further without modifications.

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Author notes

  1. T-F Wang

    Present address: Division of Hematology, Department of Medicine, The Ohio State University, Columbus, OH, USA.,

Authors and Affiliations

  1. Division of Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA

    T-F Wang, M A Fiala, A F Cashen, G L Uy, C N Abboud, T Fletcher, P Westervelt, J F DiPersio, K E Stockerl-Goldstein & R Vij

  2. Division of Biostatistics, Department of Medicine, Washington University School of Medicine, St Louis, MO, USA

    N Wu

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  1. T-F Wang
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Correspondence to R Vij.

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Competing interests

Dr Amanda Cashen is on the Speaker’s Bureau for Celgene. Dr Stockerl-Goldstein is on the Speaker’s Bureau for Celgene and Millennium. Dr Ravi Vij received honoraria from Celgene, Onyx and Millennium, research funding from Onyx and Celgene, and is on the Speaker’s Bureau for Celgene, Millennium and Teva. The remaining authors declare no conflict of interest.

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Wang, TF., Fiala, M., Cashen, A. et al. A phase II study of V-BEAM as conditioning regimen before second auto-SCT for multiple myeloma. Bone Marrow Transplant 49, 1366–1370 (2014). https://doi.org/10.1038/bmt.2014.163

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