Phase I/II study of tandem high-dose chemotherapy with autologous peripheral blood stem cell transplantation for advanced multiple myeloma

  • Kazutaka Sunami
  • Katsuji Shinagawa
  • Morio Sawamura
  • Akira Sakai
  • Yoshio Saburi
  • Yutaka Imamura
  • Ishikazu Mizuno
  • Shigehisa Tamaki
  • Tomohiko Kamimura
  • Hiroyuki Tsuda
  • Hisashi Gondo
  • Norihiko Hino
  • Chihiro Shimazaki
  • Akira Miyata
  • Fumihito Tajima
  • Yoshinobu Takemoto
  • Akiyoshi Miwa
  • Takaaki Chou
  • Mine Harada
Original Article

Abstract

The efficacy and safety of high-dose chemotherapy with tandem autologous peripheral blood stem cell transplantation (auto-PBSCT) were evaluated in a multicenter clinical study of patients with advanced multiple myeloma. Eligible patients (n = 40) were consecutively enrolled in the phase I/II study and received 2–4 cycles of vincristine–adriamycin–dexamethasone regimen. The responding patients underwent PBSC harvesting following high-dose cyclophosphamide and filgrastim administration. The first auto-PBSCT (n = 32) following high-dose melphalan (200 mg/m2) was performed within 2 months of PBSC harvesting; the second auto-PBSCT (n = 28) was scheduled 3–6 months later. Treatment-related mortality was 2.5% (n = 1) throughout the protocol. Grade 4 nonhematologic toxicity occurred in 12.5 and 14.3% of the first and second auto-PBSCT patients, respectively. All but one patient (who died) achieved hematopoietic recovery. For the 28 patients completing the second auto-PBSCT, the results were favorable with a response rate of 65% (complete response rate = 27.5%, n = 11); the five-year progression-free survival and overall survival were 20.3 and 66.5%, respectively. In conclusion, high-dose chemotherapy with tandem auto-PBSCT is feasible and safe with a favorable response rate in treating advanced multiple myeloma in Japan.

Keywords

Myeloma Auto-PBSCT Tandem 

Copyright information

© The Japanese Society of Hematology 2009

Authors and Affiliations

  • Kazutaka Sunami
    • 1
  • Katsuji Shinagawa
    • 2
  • Morio Sawamura
    • 3
  • Akira Sakai
    • 4
  • Yoshio Saburi
    • 5
  • Yutaka Imamura
    • 6
  • Ishikazu Mizuno
    • 7
  • Shigehisa Tamaki
    • 8
  • Tomohiko Kamimura
    • 9
  • Hiroyuki Tsuda
    • 10
  • Hisashi Gondo
    • 11
  • Norihiko Hino
    • 12
  • Chihiro Shimazaki
    • 13
  • Akira Miyata
    • 14
  • Fumihito Tajima
    • 15
  • Yoshinobu Takemoto
    • 16
  • Akiyoshi Miwa
    • 17
  • Takaaki Chou
    • 18
  • Mine Harada
    • 19
  1. 1.Division of Hematology, Department of Internal MedicineNational Hospital Organization Okayama Medical CenterOkayamaJapan
  2. 2.Division of Hematology/OncologyOkayama University Medical SchoolOkayamaJapan
  3. 3.Department of Internal MedicineNishigunma National HospitalShibukawaJapan
  4. 4.Department of Hematology/Oncology, Institute for Rad. Biology and MedicineHiroshima UniversityHiroshimaJapan
  5. 5.Department of HematologyOita Prefectural HospitalOitaJapan
  6. 6.Division of HematologySt. Mary’s HospitalKurumeJapan
  7. 7.Hematology Division, Department of MedicineHyogo Cancer CenterAkashiJapan
  8. 8.Department of Internal MedicineYamada Red Cross HospitalIseJapan
  9. 9.Department of HematologyHarasanshin HospitalFukuokaJapan
  10. 10.Division of Hematology/OncologyKumamoto City HospitalKumamotoJapan
  11. 11.Department of HematologyHamanomachi HospitalFukuokaJapan
  12. 12.Department of Internal MedicineKure Kyosai HospitalKureJapan
  13. 13.Division of Hematology and Oncology, Department of MedicineKyoto Prefectural University of MedicineKyotoJapan
  14. 14.Department of Internal MedicineChugoku Central Hospital of the Mutual Aid Association of Public School TeachersFukuyamaJapan
  15. 15.Division of Blood TransfusionTottori University HospitalYonagoJapan
  16. 16.Medical Corporation Kouryokai CPC ClinicKagoshimaJapan
  17. 17.Department of HematologyInternational Medical Center of JapanTokyoJapan
  18. 18.Department of Internal MedicineNiigata Cancer Center HospitalNiigataJapan
  19. 19.Department of Medicine and Biosystemic ScienceKyushu University Graduate School of Medical ScienceFukuokaJapan

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