Melphalan Conditioning Regimens Compared in Patients With Multiple Myeloma
Posted: Monday, April 23, 2018
The use of busulfan and melphalan works as an effective alternative conditioning regimen to high-dose melphalan for transplant-eligible patients with multiple myeloma, according to new findings presented at the 2018 European Society for Blood and Marrow Transplantation (EBMT) Annual Meeting in Lisbon (Abstract A159). The combination showed progression-free survival benefits for early autologous stem cell transplantation (ASCT) in patients who were treated with thalidomide-based induction therapy, concluded coauthor Sung-Soo Yoon, MD, PhD, of the Seoul National University Hospital in Korea, and colleagues.
The investigators retrospectively analyzed the records of 270 patients with newly diagnosed multiple myeloma who received busulfan and melphalan or high-dose melphalan as a conditioning regimen followed by ASCT less than 12 months from initial diagnosis. Of the patients, 76 received intravenous busulfan, administered at 3.2 mg/kg once a day on days –6 to –4, followed by melphalan, administered at 70 mg/m2 on days –3 and –2. The same number of patients received high-dose melphalan, with melphalan given at 100 mg/m2 on days –3 and –2.
After a median follow-up of 25.2 months in the busulfan/melphalan group and 60.8 months in the high-dose melphalan cohort, progression free-survival was 34.3 months and 25.1 months, respectively. Dr. Yoon and colleagues observed no statistically significant difference in the complete response and overall response rates after ASCT.
As for nonhematologic toxicity, infection was more frequently reported among the busulfan/melphalan cohort. However, the researchers found no statistically significant differences in the incidence of grade 3 infections.
