Dose-intensified bendamustine followed by autologous peripheral blood stem cell support in relapsed and refractory multiple myeloma with impaired bone marrow function
Therapeutic options in heavily pretreated relapsed/refractory multiple myeloma patients are often very limited because of impaired bone marrow function. Bendamustine is effective in multiple myeloma and has a favourable toxicity profile. We hypothesized that dose-intensified bendamustine (180 mg/m2,...
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| Main Authors: | , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2016
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| In: |
Hematological oncology
Year: 2016, Volume: 34, Issue: 4, Pages: 200-207 |
| ISSN: | 1099-1069 |
| DOI: | 10.1002/hon.2199 |
| Online Access: | Verlag, Volltext: http://dx.doi.org/10.1002/hon.2199 Verlag, Volltext: http://onlinelibrary.wiley.com/doi/10.1002/hon.2199/abstract 
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| Author Notes: | Iris Breitkreutz, Natalia Becker, Axel. Benner, Florentina Kosely, Christoph Heining, Jens Hillengass, Gerlinde Egerer, Anthony D. Ho, Hartmut Goldschmidt, Marc S. Raab |
| Summary: | Therapeutic options in heavily pretreated relapsed/refractory multiple myeloma patients are often very limited because of impaired bone marrow function. Bendamustine is effective in multiple myeloma and has a favourable toxicity profile. We hypothesized that dose-intensified bendamustine (180 mg/m2, day 1 and 2) followed by autologous blood stem cell support (ASCS) would improve bone marrow function with low post-transplant toxicity in patients with severely impaired haematopoiesis. We analyzed 28 consecutive myeloma patients, with a median of three prior lines of therapy (range 2-7), who had relapsed from the last treatment with very limited bone marrow function and were therefore ineligible for conventional chemotherapy, novel agents or trial enrolment. Dose-intensified bendamustine with ASCS improved haematopoiesis as reflected by increased platelet counts (median 40/nl vs 94/nl, p = 0.0004) and white blood cell counts (3.0/nl vs 4.8/nl, p = 0.02) at day +100. The median time until engraftment of platelets (>50/nl) was 11 days (0-24 days) and of white cell counts (>1.0/nl) 0 days (0-24 days). At least, a minimal response was achieved in 36% of patients. The disease stabilization rate was 50% while the median progression-free survival rate was limited to 2.14 months. Most importantly, patients were once again eligible for alternative treatments including enrolment into clinical trials. We conclude that dose-intensified bendamustine followed by ASCS is safe and feasible for multiple myeloma patients with very limited bone marrow reserve. Copyright © 2015 John Wiley & Sons, Ltd. |
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| Item Description: | First published: 18 March 2015 Gesehen am 06.10.2017 |
| Physical Description: | Online Resource |
| ISSN: | 1099-1069 |
| DOI: | 10.1002/hon.2199 |