No abstract

Objective High-dose ascorbic acid leads to the formation of highly reactive oxygen species due to the pro-oxidant effect, resulting in cell death; therefore, used as an additive treatment in several malignancies. We present the results obtained by administration of pharmacological dose of ascorbic acid to conventional chemotherapy in relapsed refractory multiple myeloma patients. Materials-methods Intravenous ascorbic acid at a pharmacologic dose of 15 gram/week was added to the chemotherapy regimen of relapsed refractory multiple myeloma patients, who received carfilzomib-lenalidomide-dexamethasone treatment and did not respond after the second cycle. Results The total of 4 patients who had previously received 6–9 lines of myeloma treatment were included. After 4 cycles of chemotherapy + ascorbic acid combination, 1 patient had a complete response whereas other patients had a very good partial response. Conclusion The addition of pharmacological dose ascorbic acid to conventional chemotherapy can be an effective approach in relapsed refractory patients. Clinical studies with a large number of patients will be useful to evaluate the pharmacological dose of ascorbate in plasma cell disorders.

Introduction: Sinusoidal obstruction syndrome (SOS) is one of the complications of allogeneic stem cell transplantation (allo-SCT). Defibrotide (DF) is used effectively in SOS prophylaxis and treatment. Graft versus host disease (GVHD) is a significant cause of morbidity and mortality in allo-SCT. Here, we retrospectively investigated the effect of DF on the development of GVHD in these patients. Methods: We evaluated 81 allo-transplanted patients due to various diagnoses (benign or malignant), retrospectively. Thirty-four patients used DF as prophylaxis while 47 patients did not receive it. Acute and chronic GVHD assessments were performed at +30/100th day and throughout the life of the patients, respectively. Results: Acute GVHD was more common with DF use (82% vs 61%). There was no statistical significance in terms of the effect on chronic GVHD. We observed that one patient in the non- DF group developed SOS. Conclusions: DF may be beneficial to prevent acute GVHD. However, we observed that GVHD and mortality were more common in patients using DF. This is probably due to the similarity of high-risk criteria between GVHD and SOS. We have not found a significant association between defibrotide use and the development of chronic GVHD.