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

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

Research output: Contribution to journalArticle

16 Scopus citations

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/m 2 intravenously on days-3 and-2 and CY 1 g/m 2 intravenously on days-6,-5 and-4. Overall response rate (ORR) consisting of complete response and partial response (CRPR, 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.

Original languageEnglish (US)
Pages (from-to)510-515
Number of pages6
JournalBone Marrow Transplantation
Volume46
Issue number4
DOIs
StatePublished - Apr 1 2011

Keywords

  • CY
  • autologous stem cell transplant
  • melphalan
  • multiple myeloma
  • topotecan

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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    Kazmi, S. M. A., Saliba, R. M., Donato, M., Wang, M., Hosing, C., Qureshi, S., Anderlini, P., Popat, U., Champlin, R. E., Giralt, S. A., & Qazilbash, M. H. (2011). Phase II trial of high-dose topotecan, melphalan and CY with autologous stem cell support for multiple myeloma. Bone Marrow Transplantation, 46(4), 510-515. https://doi.org/10.1038/bmt.2010.160