Total marrow irradiation as part of autologous stem cell transplantation for Asian Patients with multiple myeloma
Journal
BioMed Research International
Journal Volume
2013
Pages
321762
Date Issued
2013
Author(s)
Abstract
To compare the outcomes of melphalan 200 mg/m2 (HDM200) and 8 Gy total marrow irradiation (TMI) delivered by helical tomotherapy plus melphalan 140 mg/m2 (HDM140 + TMI 8 Gy) in newly diagnosed symptomatic multiple myeloma (MM) Asian patients. Between 2007 and 2010, nine consecutive myeloma patients who were scheduled to undergo autologous stem cell transplantation (ASCT) were studied. The patients received three cycles of vincristine- adriamycin-dexamethasone (VAD) regimen as induction chemotherapy, and if they had a partial response, peripheral blood stem cells were collected by dexamethasone-etoposide-cyclophosphamide-cisplatin (DECP). In arm A, six patients received the HDM200. In arm B, three patients received HDM140 + TMI 8 Gy. In arm B, the neutropenic duration was slightly longer than in arm A (P = 0.048). However, hematologic recovery (except for neutrophils), transfusion requirement, median duration of hospitalization, and the dose of G-CSF were similar in both arms. The median duration of overall survival and event-free survival was similar in the two arms (P = 0.387). As a conditioning regiment, HDM140 + TMI 8 Gy provide another chance for MM Asian patients who were not feasible for HDM200. ? 2013 Shih-Chiang Lin et al.
SDGs
Other Subjects
cisplatin; cyclophosphamide; dexamethasone; doxorubicin; etoposide; granulocyte colony stimulating factor; hdm 140; hdm 200; melphalan; thalidomide; unclassified drug; vincristine; antineoplastic agent; cytarabine; dexamethasone; melphalan; vincristine; adult; article; Asian; autologous stem cell transplantation; cancer combination chemotherapy; clinical article; controlled study; event free survival; feasibility study; female; follow up; hospitalization; human; induction chemotherapy; maintenance therapy; male; multimodality cancer therapy; multiple cycle treatment; multiple myeloma; neutropenia; outcome assessment; overall survival; peripheral blood stem cell; radiotherapy; randomized controlled trial; thrombocytopenia; tomotherapy; total marrow irradiation; treatment duration; aged; autotransplantation; bone marrow; bone marrow transplantation; disease free survival; middle aged; multiple myeloma; pathology; radiation; radiation exposure; stem cell transplantation; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Asian Continental Ancestry Group; Bone Marrow; Bone Marrow Transplantation; Combined Modality Therapy; Cytarabine; Dexamethasone; Disease-Free Survival; Female; Humans; Male; Melphalan; Middle Aged; Multiple Myeloma; Radiation; Stem Cell Transplantation; Transplantation, Autologous; Vincristine
Type
journal article