Intravenous busulfan and melphalan as conditioning regimen for autologous stem cell transplantation in patients with newly diagnosed multiple myeloma
Biology of Blood and Marrow Transplantation, 08/17/2012
Blanes M et al. – Autologous stem cell transplantation conditioned with intravenous busulfan plus melphalan may be considered an effective and well–tolerated alternative to a melphalan–only approach as conditioning regimen for multiple myeloma patients who are candidates for autologous stem cell transplantation.Methods
- The authors compare intravenous busulfan 9.6mg/kg and melphalan 140mg/m2 versus melphalan, 200mg/m2 as conditioning regimen before autologous stem cell transplantation for newly diagnosed patients with multiple myeloma.
- For this purpose, 51 patients receiving intravenous busulfan plus melphalan were compared to 102 patients receiving melphalan, 200mg/m2 in a 1:2 matched control analysis.
- Matching criteria included age, clinical stage at diagnosis, and response to induction therapy.
- No differences in the overall and complete response rates were observed after autologous stem cell transplantation between both groups.
- After a median follow-up of 63 and 50months in control and busulfan plus melphalan groups, progression-free survival was 24 and 33months, respectively (P=0.1).
- Most frequent toxicities included mucositis and febrile neutropenia in both groups.
- No case of sinusoidal obstruction syndrome was observed.
- Transplant-related mortality was 4% and 2% in busulfan plus melphalan and control groups, respectively.