TY - JOUR
T1 - Combination of high-dose melphalan and bortezomib as conditioning regimen for autologous peripheral blood stem cell transplantation in multiple myeloma
AU - Miyamoto, Toshihiro
AU - Yoshimoto, Goichi
AU - Kamimura, Tomohiko
AU - Muta, Tsuyoshi
AU - Takashima, Shuichiro
AU - Ito, Yoshikiyo
AU - Shiratsuchi, Motoaki
AU - Choi, Ilseung
AU - Kato, Koji
AU - Takenaka, Katsuto
AU - Iwasaki, Hiromi
AU - Takamatsu, Yasushi
AU - Teshima, Takanori
AU - Akashi, Koichi
N1 - Funding Information:
Acknowledgments We thank the nursing staff who cared for the patients at the Fukuoka BMT group. This work was supported, in part, by a Grant-in-Aid from the Ministry of Education, Culture, Sports, Science, and Technology in Japan (23390254 & 24659462 to T.M.).
PY - 2013/9
Y1 - 2013/9
N2 - Bortezomib and melphalan have synergistic effects against multiple myeloma (MM) cells. We conducted a pilot study on the combination of bortezomib and high-dose melphalan (Bor-HDM) as a conditioning regimen followed by autologous stem cell transplant (ASCT) in 17 Japanese patients with newly diagnosed MM, in comparison with a historical control of patients who received high-dose melphalan (HDM) only followed by ASCT. Nine patients received a single dose of bortezomib 1.3 mg/m2 on day -1 in combination with melphalan 100 mg/m2 on days -3 and -2 (Bor1-HDM), and eight received two doses of bortezomib 1.3 mg/m2 on days -4 and -1 (Bor2-HDM) in combination with HDM. Engraftment of autologous peripheral blood stem cells and regimen-related toxicities (RRT) were comparable among the HDM and Bor-HDM groups. Probability of upgrading from a less than very good partial response (VGPR) to VGPR after ASCT was approximately two times higher in the Bor-HDM group than in the HDM group. However, we observed no significant differences in engraftment, RRT, and response rates between the Bor1-HDM and Bor2-HDM groups. The present study showed that concurrent administration of at least two doses of bortezomib in combination with HDM can be safe in Japanese patients. Additional large prospective randomized trials are required to address the optimal dosages and schedules of bortezomib administration, as well as the efficacy of the Bor-HDM conditioning regimen for ASCT.
AB - Bortezomib and melphalan have synergistic effects against multiple myeloma (MM) cells. We conducted a pilot study on the combination of bortezomib and high-dose melphalan (Bor-HDM) as a conditioning regimen followed by autologous stem cell transplant (ASCT) in 17 Japanese patients with newly diagnosed MM, in comparison with a historical control of patients who received high-dose melphalan (HDM) only followed by ASCT. Nine patients received a single dose of bortezomib 1.3 mg/m2 on day -1 in combination with melphalan 100 mg/m2 on days -3 and -2 (Bor1-HDM), and eight received two doses of bortezomib 1.3 mg/m2 on days -4 and -1 (Bor2-HDM) in combination with HDM. Engraftment of autologous peripheral blood stem cells and regimen-related toxicities (RRT) were comparable among the HDM and Bor-HDM groups. Probability of upgrading from a less than very good partial response (VGPR) to VGPR after ASCT was approximately two times higher in the Bor-HDM group than in the HDM group. However, we observed no significant differences in engraftment, RRT, and response rates between the Bor1-HDM and Bor2-HDM groups. The present study showed that concurrent administration of at least two doses of bortezomib in combination with HDM can be safe in Japanese patients. Additional large prospective randomized trials are required to address the optimal dosages and schedules of bortezomib administration, as well as the efficacy of the Bor-HDM conditioning regimen for ASCT.
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U2 - 10.1007/s12185-013-1402-0
DO - 10.1007/s12185-013-1402-0
M3 - Article
C2 - 23877150
AN - SCOPUS:84884672057
VL - 98
SP - 337
EP - 345
JO - International Journal of Hematology
JF - International Journal of Hematology
SN - 0925-5710
IS - 3
ER -