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Conditioning Regimens

Phase II trial of high-dose topotecan, melphalan and CY with autologous stem cell support for multiple myeloma

Bone Marrow Transplantation volume 46, pages 510–515 (2011)Cite this article

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Abstract

In spite of high-dose chemotherapy followed by autologous hematopoietic SCT multiple myeloma (MM) eventually recurs, highlighting the need for more effective treatment approaches. Patients received topotecan 3.5 mg/m2 intravenously on days –6 to –2, melphalan 70 mg/m2 intravenously on days –3 and –2 and CY 1 g/m2 intravenously on days –6, –5 and –4. Overall response rate (ORR) consisting of complete response and partial response (CR+PR, PFS, OS and toxicity are reported. Between August 2002 to March 2004, 60 patients (34 men and 26 women) with a median age of 61 years (range 45–72) were enrolled. Forty-one patients were treated for consolidation of first remission, while 19 patients had relapsed/refractory disease. ORR was 85% (CR 12%, very good PR 43% and PR 30%). Median time to neutrophil (ANC>0.5 × 109/L) and plt engraftment (>20 × 109/L) was 10 (range 7–12 days) and 9 days (range 6–79 days), respectively. A majority of the common adverse events were grade 1–3 mucositis/stomatitis (65%), grade 1 or 2 nausea (59%) and grade 1 or 2 diarrhea (41%). Median PFS was 18.5 months and median OS has yet not been reached. In conclusion, topotecan, melphalan and CY is a safe and active conditioning regimen for auto hematopoietic SCT in MM. The ORR and PFS were comparable to high-dose melphalan.

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Authors and Affiliations

  1. Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA

    S M A Kazmi

  2. Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, TX, USA

    R M Saliba, M Donato, C Hosing, S Qureshi, P Anderlini, U Popat, R E Champlin, S A Giralt & M H Qazilbash

  3. Department of Lymphoma and Myeloma, University of Texas MD Anderson Cancer Center, Houston, TX, USA

    M Wang

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  1. S M A Kazmi
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Correspondence to M H Qazilbash.

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Kazmi, S., Saliba, R., Donato, M. et al. Phase II trial of high-dose topotecan, melphalan and CY with autologous stem cell support for multiple myeloma. Bone Marrow Transplant 46, 510–515 (2011). https://doi.org/10.1038/bmt.2010.160

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