Cyclophosphamide’s addition in relapsed/refractory multiple myeloma patients with biochemical progression during lenalidomide‐dexamethasone treatment

Cesini, Laura; Siniscalchi, Agostina; Grammatico, Sara; Andriani, Alessandro; Fiorini, Alessia; Rosa, Luca De; Zà, Tommaso; Rago, Angela; Caravita, Tommaso; Petrucci, Maria Teresa

doi:10.1111/ejh.13086

Cited by 3 publications

(4 citation statements)

References 26 publications

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“…Median OS was 18 months from the addition of cyclophosphamide and PFS was 13 months. 79 Another center reported SD or better in 87% of 53 patients who had weekly cyclophosphamide, at a dose of 250-500 mg, added to len/dex at the time of progression. 80 Cyclophosphamide also shows synergy with pomalidomide.…”

Section: Immunomodulatory Agents (Imids)mentioning

confidence: 99%

“…10 patients achieved stable disease (SD), 6 a partial response (PR) and 3 a very good partial response (VGPR). Median OS was 18 months from the addition of cyclophosphamide and PFS was 13 months 79 . Another center reported SD or better in 87% of 53 patients who had weekly cyclophosphamide, at a dose of 250–500 mg, added to len/dex at the time of progression 80 …”

Section: Immunomodulatory Role Within MM Treatment Regimens – Synergy...mentioning

confidence: 99%

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Beyond DNA Damage: Exploring the Immunomodulatory Effects of Cyclophosphamide in Multiple Myeloma

et al. 2020

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The alkylating agent cyclophosphamide has been used in the treatment of multiple myeloma for over 60 years. At low doses, cyclophosphamide also has significant immunomodulatory activity, which can be used to modify the immunosuppressive tumor microenvironment in order to augment responses to existing therapies. Immune-mediated therapies are becoming more widespread in modern approaches to myeloma treatment. In this review, we discuss the effects cyclophosphamide has on the immune system, and how it can be used synergistically with other treatment modalities including the immunomodulatory agents, monoclonal antibodies and cellular therapies.

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Section: Immunomodulatory Agents (Imids)mentioning

confidence: 99%

Section: Immunomodulatory Role Within MM Treatment Regimens – Synergy...mentioning

confidence: 99%

Beyond DNA Damage: Exploring the Immunomodulatory Effects of Cyclophosphamide in Multiple Myeloma

et al. 2020

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“…Numerous studies have been carried out to assess the potential benefits of combining this alkylating agent with the novel drugs. Most of them give promising results, especially for refractory and relapsed patients 16‐18 . As Cy activity is well known when given as part of MM treatment, it is possible that Cy‐based mobilization might further improve complete remission (CR) rates in a patients undergoing ASCT.…”

Section: Introductionmentioning

confidence: 99%

“…Most of them give promising results, especially for refractory and relapsed patients. [16][17][18] As Cy activity is well known when given as part of MM treatment, it is possible that Cy-based mobilization might further improve complete remission (CR) rates in a patients undergoing ASCT. Cyclophosphamide with G-CSF is given at low, intermediate or high doses, either of which seem to be comparable with the rate of successful collection at about 80%.…”

Section: Introductionmentioning

confidence: 99%

Higher efficacy of intermediate dose cytarabine + G‐CSF compared to cyclophosphamide + G‐CSF in hematopoietic stem cell mobilization in patients with multiple myeloma

Bogucka-Fedorczuk

Czyż

Kalicińska

et al. 2020

J of Clinical Apheresis

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Background There are several regimens used in hematopoietic stem cell (HSC) mobilization in multiple myeloma (MM). Cyclophosphamide (Cy) is one of the most commonly used agents, although it does not always result in collecting adequate number of CD34+ cells. Recently, cytarabine (Ara‐C) has been proposed as potentially efficient and safe option. Aims Since the data regarding Ara‐C in HSC mobilization is limited, the aim of our study was to compare retrospectively the efficiency and toxicity of G‐CSF combined with either Ara‐C or Cy in MM patients. Materials & Methods Of a total of 89 patients, 43 received low or intermediate doses of Cy, and 46 were treated with 800 mg/m2/day of Ara‐C administered for two days. Results The mean peak of CD34+ cells/ul in peripheral blood was 132 (range, 84‐202) in Ara‐C and 51 (range, 29‐69) in Cy cohort (p < 0.001). The median number of collected CD34+ cells (×106/kg) was 10.3 (range, 4.2‐17.9) vs 4.5 (range, 2.7‐8.9), respectively (p < 0.001). Mobilization failure was observed in one patient in Ara‐C cohort (2%) and in 8 patients treated with Cy (19%) (p = 0.013). In the Ara‐C group 98% of patients obtained more than 4×106 CD34+ cells/kg required for tandem transplantation. Moreover, we observed a trend toward increased paraprotein levels measured at transplant compared to before HSC mobilization in Ara‐C cohort and significantly higher transfusion rates in that group. Conclusion Our findings confirm higher HSC mobilization efficacy of Ara‐C compared to Cy in MM patients. However, lower transfusions rate and better disease control of Cy may justify its use in some cases.

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Addition of Cyclophosphamide “On Demand” to Lenalidomide and Corticosteroids in Patients With Relapsed/Refractory Multiple Myeloma—A Retrospective Review of a Single-center Experience

Alahmadi

Masih‐Khan

Atenafu

et al. 2019

Clinical Lymphoma Myeloma and Leukemia

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Cyclophosphamide’s addition in relapsed/refractory multiple myeloma patients with biochemical progression during lenalidomide‐dexamethasone treatment

Abstract: The addition of cyclophosphamide delays the progression in patients who present a biochemical relapse during Rd treatment. The response rate and the duration of PFS obtained with minimal toxicities and low costs induced us to setting up a randomized clinical trial.

Cited by 3 publications

References 26 publications

Beyond DNA Damage: Exploring the Immunomodulatory Effects of Cyclophosphamide in Multiple Myeloma

Beyond DNA Damage: Exploring the Immunomodulatory Effects of Cyclophosphamide in Multiple Myeloma

Higher efficacy of intermediate dose cytarabine + G‐CSF compared to cyclophosphamide + G‐CSF in hematopoietic stem cell mobilization in patients with multiple myeloma

Addition of Cyclophosphamide “On Demand” to Lenalidomide and Corticosteroids in Patients With Relapsed/Refractory Multiple Myeloma—A Retrospective Review of a Single-center Experience

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