High-Dose Sequential Therapy and Single Autologous Transplantation for Multiple Myeloma
| Status: | Completed |
|---|---|
| Conditions: | Blood Cancer, Hematology, Hematology |
| Therapuetic Areas: | Hematology, Oncology |
| Healthy: | No |
| Age Range: | 18 - 75 |
| Updated: | 12/14/2017 |
| Start Date: | August 2006 |
| End Date: | April 2010 |
This study uses a sequence of high-dose chemotherapy drugs and a stem cell transplant to
treat multiple myeloma. The study is being performed to evaluate the efficacy and side
effects of treatment. Specifically, the study is designed to reduce the risk of interstitial
pneumonitis.
treat multiple myeloma. The study is being performed to evaluate the efficacy and side
effects of treatment. Specifically, the study is designed to reduce the risk of interstitial
pneumonitis.
Analysis of 196 previously treated patients demonstrated a median event-free survival (EFS)
of 36 months with a median overall survival of more than 6 years. The main toxicity of this
therapy is related to carmustine-induced pneumonitis or interstitial pneumonitis (IP). This
complication is related to the dose of carmustine. Institutional experience in myeloma
patients using this dose of carmustine indicates an incidence of IP of34%.
There have been recent studies evaluating the role of tandem autologous transplants for
patients with multiple myeloma. These trials were based upon the hypothesis that performing
tandem high-dose therapy regimens would lead to increased tumor cell kill, decreased tumor
burden and an improvement in overall survival. Our results with high-dose sequential therapy
including the dose-intense carmustine/melphalan transplant demonstrates similar median EFS
and overall survival (OS) when compared with the results of tandem transplant approaches.The
proposed trial will continue to use a high-dose sequential transplant approach, however, we
will use a reduced dose of carmustine which we expect to be associated with a lower incidence
of IP.
of 36 months with a median overall survival of more than 6 years. The main toxicity of this
therapy is related to carmustine-induced pneumonitis or interstitial pneumonitis (IP). This
complication is related to the dose of carmustine. Institutional experience in myeloma
patients using this dose of carmustine indicates an incidence of IP of34%.
There have been recent studies evaluating the role of tandem autologous transplants for
patients with multiple myeloma. These trials were based upon the hypothesis that performing
tandem high-dose therapy regimens would lead to increased tumor cell kill, decreased tumor
burden and an improvement in overall survival. Our results with high-dose sequential therapy
including the dose-intense carmustine/melphalan transplant demonstrates similar median EFS
and overall survival (OS) when compared with the results of tandem transplant approaches.The
proposed trial will continue to use a high-dose sequential transplant approach, however, we
will use a reduced dose of carmustine which we expect to be associated with a lower incidence
of IP.
INCLUSION CRITERIA
- Stage II to III multiple myeloma, or progression after initial treatment of Stage I
disease; early or relapsed
- Age 18 to 75 years.
- Pathology reviewed and the diagnosis confirmed at Stanford University Medical Center.
- Patients with amyloidosis may be eligible for this trial, with approval by the
Principle Investigator.
- Patients must have a Karnofsky performance status > 70%.
- Aspartate aminotransferase (AST) must be < 2 x upper limit of normal (ULN)
- Alanine aminotransferase (ALT) must be < 2 x ULN
- Total bilirubin < 2 mg/dL.
- Serum creatinine < 2.0 or 24-hour creatinine clearance ≥ 60 mL/min.
- Patients must be HIV-negative.
- Patients must provide signed, informed consent.
EXCLUSION CRITERIA
- Severe psychological or medical illness
- Prior autologous hematopoietic cell transplantation
- Pregnant
- Lactating women
- Smoldering multiple myeloma,
- Monoclonal gammopathy of unknown significance or primary amyloidosis will be excluded
from this study
We found this trial at
1
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Stanford University School of Medicine Vast in both its physical scale and its impact on...
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