High-dose chemotherapy with autologous hematopoietic stem cell transplantation in patients with multiple myeloma

Gertz, Morie A.; Lacy, Martha Q.; Dispenzieri, Angela; Hayman, Suzanne R.; Kumar, Shaji

doi:10.1586/14737140.6.3.343

Cited by 20 publications

(10 citation statements)

References 110 publications

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“…Although not curative, tandem high-dose chemotherapy with melphalan followed by autologous peripheral blood progenitor cell transplantation (PBSCT) remains the standard of therapy for eligible multiple myeloma patients (Gahrton 2005;Gertz et al 2006). From the beginning of autologous transplantation in the treatment of malignant diseases, the contamination of autologous grafts has been implicated as a reason for relapse.…”

Section: Introductionmentioning

confidence: 99%

Contamination of autologous peripheral blood progenitor cell grafts predicts overall survival after high-dose chemotherapy in multiple myeloma

Kopp

Yıldırım

Weisel

et al. 2008

J Cancer Res Clin Oncol

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Patients with >4.5 x 10(5) plasma cells/kg contaminating the peripheral blood stem cell graft received after high-dose chemotherapy have a significantly reduced overall survival. Whether high contamination of grafts with plasma cells might reflect residual in vivo tumor mass prior to stem cell transplantation and a generally more aggressive behavior of malignant myeloma cells in these patients, or whether reinfused plasma cells contribute to an unfavorable course of disease remains to be determined.

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Section: Introductionmentioning

confidence: 99%

Contamination of autologous peripheral blood progenitor cell grafts predicts overall survival after high-dose chemotherapy in multiple myeloma

Kopp

Yıldırım

Weisel

et al. 2008

J Cancer Res Clin Oncol

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“…The achievement of a higher CR rate is important, as CR following transplant is prognostic for better survival [5,7,11 -18], as is CR following conventional chemotherapy [19,20]. Indeed, it is likely that the introduction and widespread use of HDT-ASCT in frontline therapy for multiple myeloma has contributed to the increase in survival at 5 years seen over the past 30 years [2].…”

Section: Introductionmentioning

confidence: 99%

“…Frontline treatment for multiple myeloma incorporating HDT-ASCT typically comprises induction chemotherapy, stem cell mobilization with G-CSF or GM-CSF and/or cyclophosphamide, harvesting of stem cells usually from the blood (PBSCs) by apheresis, conditioning using high-dose melphalan (typically 200 mg/m 2 ), and stem cell reinfusion leading to engraftment [1,2]. Double (tandem) transplants may be performed to increase CR rates [3,6,21], and may offer improved OS compared with single transplants, particularly for patients who have not achieved at least a very good partial response (PR) after undergoing one transplant [3,12].…”

Section: Introductionmentioning

confidence: 99%

Use of bortezomib as induction therapy prior to stem cell transplantation in frontline treatment of multiple myeloma: Impact on stem cell harvesting and engraftment

Oakervee

Popat

Cavenagh

2007

Leukemia & Lymphoma

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High-dose melphalan therapy with peripheral blood stem cell (PBSC) transplantation is a standard treatment for younger patients with untreated multiple myeloma that results in high overall and complete response (CR) rates, and improved event-free and overall survival compared with standard chemotherapy alone. Induction therapy serves to reduce tumor burden prior to stem cell mobilization and thus must not adversely impact stem cell mobilization and harvesting, or engraftment following high dose therapy plus autologous stem cell transplantation. Bortezomib, an approved agent for the treatment of multiple myeloma patients who have received at least one prior therapy, is also being investigated in the frontline setting. Preclinical studies have demonstrated that bortezomib has no toxic effects on stem cells, megakaryocytes or neutrophil precursors, and causes only transient and reversible thrombocytopenia and neutropenia. Clinical studies with bortezomib-based induction regimens have demonstrated no adverse impact on PBSC harvest numbers nor on their quality as defined by engraftment times. These regimens appear to be well tolerated and highly active as induction therapy, with high response rates and consistently high CR rates. Randomized phase 3 studies comparing bortezomib-based regimens with current standard induction therapies are ongoing.

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“…High-dose melphalan 200 mg/m 2 supported by ASCT is a well-established therapy for patients with MM (Gertz, Lacy, Dispenzieri, Hayman, & Kumar, 2006). The drug is considered the standard of care for patients younger than age 65 and select older patients of various ethnicities (Barlogie et al, 2004;Gertz et al;Jantunen et al, 2006;Rajkumar, Gertz, Kyle, & Greipp, 2002;Saraf et al, 2006;Singhal, 2002).…”

Section: Therapies Conventional Chemotherapy Versus Single Autologousmentioning

confidence: 99%

“…The drug is considered the standard of care for patients younger than age 65 and select older patients of various ethnicities (Barlogie et al, 2004;Gertz et al;Jantunen et al, 2006;Rajkumar, Gertz, Kyle, & Greipp, 2002;Saraf et al, 2006;Singhal, 2002). For patients who are not good candidates for transplantation, several other standard therapies are available, single agents such as bortezomib, thalidomide, and high-dose dexamethasone (Colson, Doss, Swift, Tariman, & Thomas, 2004;National Comprehensive Cancer Network, 2005;Tariman, 2003Tariman & Estrella, 2005).…”

Section: Therapies Conventional Chemotherapy Versus Single Autologousmentioning

confidence: 99%

The Role of High-Dose Chemotherapy Supported by Hematopoietic Stem Cell Transplantation in Patients With Multiple Myeloma: Implications for Nursing

Rodriguez¹,

Tariman²,

Enecio³

et al. 2007

Clinical Journal of Oncology Nursing

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Multiple myeloma (MM), a neoplastic proliferation of plasma cells originating from the B-cell line, is associated with deleterious complications and poor outcomes. The failure of conventional combination chemotherapies to improve the overall survival of patients with MM has led to the use of high-dose chemotherapy supported by stem cell transplantation (SCT). Although several novel therapies have emerged since the late 1990s, their survival benefits are undetermined. Highdose chemotherapy with SCT provides better response rates compared to conventional chemotherapy and yields a trend toward greater survival benefits, especially with the use of a tandem (two successive) transplantation strategy. This article discusses standard SCT in patients with MM and some of the new transplantation strategies, including tandem autologous SCTs and reduced-intensity nonmyeloablative allogeneic SCT, and their implications for nursing.The role of high-dose chemotherapy supported by stem cell transplantation (SCT) as a safe and effective therapy for patients with multiple myeloma (MM) is well established (Singhal, 2002). Since the 1990s, myeloma treatment advances have been made in the transplantation arena, but major challenges still lie ahead to improve overall survival (Barlogie et al., 2004). Several transplantation-related strategies have emerged, including tandem (i.e., two successive) autologous SCTs (ASCTs), autologous followed by allogeneic SCT, nonmyeloablative allogeneic transplantation, and sequential ASCTs followed by Author Contact: Anna Liza Rodriguez, RN, BSN, OCN ® , can be reached at anrodrig@nmh.org, with copy to editor at CJONEditor@ons.org. No financial relationships to disclose. NIH Public Access Author ManuscriptClin J Oncol Nurs. Author manuscript; available in PMC 2014 October 17. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript nonmyeloablative allogeneic transplantation, all in an effort to improve overall survival (Hari, Pasquini, & Vesole, 2006). Although several novel agents such as thalidomide, bortezomib, and lenalidomide have been effective in the treatment of MM, their impact on overall survival and quality of life in patients with MM is unclear . This article discusses standard SCT in patients with MM, some of the newer transplantation strategies (e.g., tandem ASCT, reduced-intensity nonmyeloablative allogeneic SCT) and their implications for nursing. Multiple Myeloma OverviewMM is the abnormal clonal proliferation of plasma cells originating from the B-cell line. An estimated 19,900 new myeloma cases and 10,790 deaths caused by the disease are anticipated in (Jemal et al., 2007. Many patients diagnosed with myeloma tend to be older (median age at diagnosis is 66), but some cases in patients younger than 40 have been reported (Kyle et al., 2003).MM is a neoplastic growth from the single clone of a plasma cell that became aberrant and proliferated in an uncontrolled pattern with eventual accumulation in the bone marrow. Myeloma cells produce abnormal and dysfuncti...

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High-dose chemotherapy with autologous hematopoietic stem cell transplantation in patients with multiple myeloma

Cited by 20 publications

References 110 publications

Contamination of autologous peripheral blood progenitor cell grafts predicts overall survival after high-dose chemotherapy in multiple myeloma

Contamination of autologous peripheral blood progenitor cell grafts predicts overall survival after high-dose chemotherapy in multiple myeloma

Use of bortezomib as induction therapy prior to stem cell transplantation in frontline treatment of multiple myeloma: Impact on stem cell harvesting and engraftment

The Role of High-Dose Chemotherapy Supported by Hematopoietic Stem Cell Transplantation in Patients With Multiple Myeloma: Implications for Nursing

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