Korean J Hematol.  2010 Sep;45(3):183-187. 10.5045/kjh.2010.45.3.183.

Bortezomib and melphalan as a conditioning regimen for autologous stem cell transplantation in multiple myeloma

Affiliations
  • 1Department of Internal Medicine, Korea University Medical Center, Seoul, Korea.
  • 2Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. kstwoh@skku.edu

Abstract

BACKGROUND
High-dose melphalan (200 mg/m2) with autologous stem cell transplantation (ASCT) is the standard treatment for young patients with multiple myeloma (MM). However, the response rates after ASCT are often unsatisfactory. We performed a pilot study by using bortezomib-melphalan as conditioning regimen for ASCT in Korean patients with MM.
METHODS
The conditioning regimen consisted of administration of intravenous infusion of bortezomib 1.0 mg/m2 on days -4 and -1 and melphalan 50 mg/m2 (day -4) and 150 mg/m2 (day -1). In this study, we enrolled 6 newly diagnosed patients and 2 patients with relapse.
RESULTS
The disease status of the 6 newly diagnosed patients at ASCT was as follows: 1 complete remission (CR), 1 very good partial remission (VGPR), and 4 partial remissions (PRs). The disease status of the 2 relapsed patients at ASCT was PR. All patients except 1 showed adequate hematologic recovery after ASCT. The median time for the absolute neutrophil counts to increase over 500/mm3 was 13 days (range, 10-19 days). Six patients with VGPR or PR at the time of transplantation showed an improvement in response to CR after ASCT. The patients were followed up without any maintenance treatment after ASCT except 1 patient who died during ASCT. During the follow-up period, CR was maintained in 3 newly diagnosed patients, but the other 4 patients, including 2 newly diagnosed patients, relapsed.
CONCLUSION
Conditioning regimen consisting of bortezomib and melphalan may be effective for ASCT in MM; however, the feasibility of this regimen should be further evaluated in large study populations.

Keyword

Multiple myeloma; Bortezomib; Melphalan

MeSH Terms

Boronic Acids
Follow-Up Studies
Humans
Infusions, Intravenous
Melphalan
Multiple Myeloma
Neutrophils
Pilot Projects
Pyrazines
Recurrence
Stem Cell Transplantation
Stem Cells
Transplants
Bortezomib
Boronic Acids
Melphalan
Pyrazines

Figure

  • Fig. 1 Schematic diagram of the bortezomib and melphalan conditioning regimen. B, bortezomib 1 mg/m2; M50, melphalan 50 mg/m2; M150, melphalan 150 mg/m2; PBSC, peripheral blood stem cell.


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