Contributions
Abstract: PB2010
Type: Publication Only
Background
Multiple myeloma (MM) patients refractory to proteasome inhibitors, IMIDs or both, have an extremely poor prognosis. Moreover, they frequently fail to respond to further therapies, and represent a major challenge in everyday clinical practice.
Aims
With this in mind, we treated 12 patient with relapsed MM with a single shot of medium dose melphalan (60 mg/m2) between October 2010 and January 2016.
Methods
The median age was 72 years (range, 62 – 79) and the median time from initial diagnosis until melphalan treatment was 51 months (range, 24 – 144). Patients were heavily pretreated with a median number of 3 prior lines of therapy. All patients were refractory to the previous therapeutic regimens and had failed to respond or were refractory to regimens containing bortezomib. Seven patients (84%) had previously received at least one IMiD, 8 (67%) autologous stem cell transplantation (ASCT) and 1 allogeneic stem cell transplantation. The patients included in the series were not eligible for any clinical trial available at the Institution. All patients gave informed consent.
Results
All patients had cytopenia (anemia, neutropenia and thrombocytopenia). We observed 3 cases of gastrointestinal toxicity (1 bleeding, 1 subocclusion, 1 mucositis grade IV sec. WHO), 3 cases of clinically documented infection (1 Escherichia coli bacteremia, 1 fever of unknown origin, 1 erysipela) and 2 deep vein thrombosis. Response was assessed between six and eight weeks after melphalan therapy. Overall, 10 out of 12 patients had a response ( 1 complete response, 3 very good partial response, 2 partial response and 4 stable disease); only 2 had progressive disease. Median overall survival was 11 months (range, 2 -37). 10 of 12 patients relapsed after a median time of 5 months (range: 2-12). Concerning two patients not relapsed, 1 patient died in partial response 8 months after therapy of other causes; 1 patient is still alive, in complete remission 18 months after melphalan. He underwent ASCT and maintenance with lenalidomide.
Conclusion
Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical
Keyword(s): Relapse, Multiple Myeloma, Melphalan
Abstract: PB2010
Type: Publication Only
Background
Multiple myeloma (MM) patients refractory to proteasome inhibitors, IMIDs or both, have an extremely poor prognosis. Moreover, they frequently fail to respond to further therapies, and represent a major challenge in everyday clinical practice.
Aims
With this in mind, we treated 12 patient with relapsed MM with a single shot of medium dose melphalan (60 mg/m2) between October 2010 and January 2016.
Methods
The median age was 72 years (range, 62 – 79) and the median time from initial diagnosis until melphalan treatment was 51 months (range, 24 – 144). Patients were heavily pretreated with a median number of 3 prior lines of therapy. All patients were refractory to the previous therapeutic regimens and had failed to respond or were refractory to regimens containing bortezomib. Seven patients (84%) had previously received at least one IMiD, 8 (67%) autologous stem cell transplantation (ASCT) and 1 allogeneic stem cell transplantation. The patients included in the series were not eligible for any clinical trial available at the Institution. All patients gave informed consent.
Results
All patients had cytopenia (anemia, neutropenia and thrombocytopenia). We observed 3 cases of gastrointestinal toxicity (1 bleeding, 1 subocclusion, 1 mucositis grade IV sec. WHO), 3 cases of clinically documented infection (1 Escherichia coli bacteremia, 1 fever of unknown origin, 1 erysipela) and 2 deep vein thrombosis. Response was assessed between six and eight weeks after melphalan therapy. Overall, 10 out of 12 patients had a response ( 1 complete response, 3 very good partial response, 2 partial response and 4 stable disease); only 2 had progressive disease. Median overall survival was 11 months (range, 2 -37). 10 of 12 patients relapsed after a median time of 5 months (range: 2-12). Concerning two patients not relapsed, 1 patient died in partial response 8 months after therapy of other causes; 1 patient is still alive, in complete remission 18 months after melphalan. He underwent ASCT and maintenance with lenalidomide.
Conclusion
Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical
Keyword(s): Relapse, Multiple Myeloma, Melphalan