Dose-intensified bendamustine and melphalan (BenMel) conditioning before second autologous transplantation in myeloma patients.

Farag, Sarah Ahmed Ibrahim; Jeker, Barbara; Bacher, Vera Ulrike; Mansouri Taleghani, Behrouz; Müller, Beatrice Ursula; Novak, Urban; Pabst Müller, Thomas Niklaus (2018). Dose-intensified bendamustine and melphalan (BenMel) conditioning before second autologous transplantation in myeloma patients. Hematological oncology, 36(4), pp. 671-678. Wiley 10.1002/hon.2546

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Consolidation in myeloma patients with high-dose melphalan chemotherapy (Mel HDCT) and autologous transplantation (ASCT) is standard of care since more than 2 decades. However, definite cure remains exceptional despite intensive treatment, and improving effectiveness of HDCT remains an unmet clinical need. Combining intensified bendamustine with melphalan may represent an option. We analyzed safety and efficacy of combining dose-intensified bendamustine (200 mg/m on days -4/-3) with high-dose melphalan (100 mg/m on days -2/-1) before a second (tandem) ASCT in adverse risk myeloma patients after Mel HDCT/ASCT1. Twelve patients received BenMel conditioning before ASCT2 because of high-risk cytogenetics and/or failure to achieve complete remission (CR) after Mel HDCT/ASCT1. Comparing Mel HDCT/ASCT1 and BenMel HDCT/ASCT2, we observed no differences in hematologic recovery and tolerance. Acute renal injury after BenMel conditioning occurred in 3 (25%) patients, but was reversible in all patients, and there were no treatment related deaths. Complete remission rates were increasing from 42% after Mel/ASCT1 to 75% after BenMel/ASCT2. PFS 1 year after ASCT2 was 67%, and OS was 83%. These data suggest that dose-intensified bendamustine with melphalan conditioning is safe and warrants a prospective randomized comparison to standard melphalan HDCT in myeloma patients.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Med. Onkologie / Hämatologie (Erw.)
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Med. Onkologie / Hämatologie (Erw.)

04 Faculty of Medicine > Service Sector > Institute of Pathology
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Haematology and Central Haematological Laboratory
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Medical Oncology

UniBE Contributor:

Farag, Sarah Ahmed Ibrahim; Jeker, Barbara; Bacher, Vera Ulrike; Mansouri Taleghani, Behrouz; Müller, Beatrice Ursula; Novak, Urban and Pabst Müller, Thomas Niklaus

Subjects:

600 Technology > 610 Medicine & health
500 Science > 570 Life sciences; biology

ISSN:

1099-1069

Publisher:

Wiley

Language:

English

Submitter:

Pierrette Durand Lüthi

Date Deposited:

27 Mar 2019 16:16

Last Modified:

27 Oct 2019 11:14

Publisher DOI:

10.1002/hon.2546

PubMed ID:

30110717

Uncontrolled Keywords:

autologous transplantation bendamustine conditioning high-dose chemotherapy intensified melphalan myeloma remission response

BORIS DOI:

10.7892/boris.120302

URI:

https://boris.unibe.ch/id/eprint/120302

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