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Busulfan, melphalan, and bortezomib compared to melphalan as a high dose regimen for autologous hematopoietic stem cell transplantation in multiple myeloma: long term follow up of a novel high dose regimen. Leuk Lymphoma 2020 Dec;61(14):3484-3492

Date

09/01/2020

Pubmed ID

32865474

Pubmed Central ID

PMC7786301

DOI

10.1080/10428194.2020.1811275

Scopus ID

2-s2.0-85089967898 (requires institutional sign-in at Scopus site)   4 Citations

Abstract

Melphalan at a dose of 200 mg/m2 (MEL200) remains the standard high dose therapy before autologous stem cell transplantation (ASCT) for multiple myeloma (MM). Intensifying the high dose regimen has shown promising results. We report here 7-year follow up of our novel high dose regimen of busulfan and melphalan followed by bortezomib (BuMelVel). Forty-three MM patients received BuMelVel high dose therapy with pharmacokinetic adjusted busulfan. Outcomes were compared to a matched control cohort from the CIBMTR database (n = 162) receiving MEL200. The primary endpoint was progression free survival. Five year PFS was 47% v 30% (95% CI; 32-62) in favor or the BuMelVel group (95% CI; 23-37) (p = 0.05). In multivariate analysis for PFS, BuMelVel (HR 0.65; 95% CI 0.44-0.97)(p = 0.036) was predictive. Similar to recent reports of double alkylator therapy, although depth of response was similar between the BuMelVel group and MEL200, the BUMELVEL group experienced an improved PFS.

Author List

Hagen P, D'Souza A, Hari P, Davila O, Zhang MJ, Vesole DH, Smith SE, Rodriguez TE, Stiff PJ

Authors

Anita D'Souza MD Associate Professor in the Medicine department at Medical College of Wisconsin
Parameswaran Hari MD Adjunct Professor in the Medicine department at Medical College of Wisconsin
Mei-Jie Zhang PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Antineoplastic Combined Chemotherapy Protocols
Bortezomib
Busulfan
Follow-Up Studies
Hematopoietic Stem Cell Transplantation
Humans
Melphalan
Multiple Myeloma
Transplantation Conditioning
Transplantation, Autologous