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Myeloma

High-dose idarubicine, busulphan and melphalan as conditioning for autologous blood stem cell transplantation in multiple myeloma. A feasibility study

Bone Marrow Transplantation volume 26, pages 1045–1049 (2000)Cite this article

Abstract

Extensive studies have tested the clinical impact of double and triple sequential transplants as front-line therapy in MM, following the suggestion that dose escalation can overcome the marked drug resistance characteristic of this disease, but the superiority of such approaches vsone single transplant has still to be demonstrated. The aim of our study was to evaluate the feasibility and efficacy of high-dose idarubicine intensification of a standard busulphan–melphalan conditioning regimen in MM. Twenty-eight patients (median age 55 years) with sensitive disease received PBSCT after high-dose idarubicine combined with busulphan and melphalan and followed by s.c. rhG-CSF until PMN recovery. The most severe toxicity was represented by oral mucositis which resolved with hemopoietic reconstitution. Overall response and CR rate were 52% and 40%, respectively. Currently, 36 patients are alive and 19 are progression-free a median of 20 months (12–36) from transplant. The 3-year projected probability of progression-free survival for patients transplanted after first-line treatment is 60%. The combination of Ida/Bu/Melph appears a promising alternative regimen for PBSCT in myeloma, with low transplant-related toxicity and fast hematological recovery. Long-term follow-up and a prospective randomized study, now ongoing, will probably clarify whether an idarubicine-intensified regimen will result in superior outcomes to conventional conditioning and even be comparable to a double consecutive transplant program. Bone Marrow Transplantation (2000) 26, 1045–1049.

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Acknowledgements

We acknowledge the support of Pharmacia and Upjohn in providing idarubicine; we particularly thank Dr Theo De Witte for kindly revising the manuscript. This work was supported by MURST 40%.

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Authors and Affiliations

  1. Department of Biotecnologie Cellulari ed Ematologia, University ‘La Sapienza’, Roma, Italy

    G Meloni, S Capria, S Trasarti, G Ferrazza, A Micozzi, MT Petrucci, F Simone, SM Trisolini & F Mandelli

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  1. G Meloni
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  2. S Capria
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Meloni, G., Capria, S., Trasarti, S. et al. High-dose idarubicine, busulphan and melphalan as conditioning for autologous blood stem cell transplantation in multiple myeloma. A feasibility study. Bone Marrow Transplant 26, 1045–1049 (2000). https://doi.org/10.1038/sj.bmt.1702668

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