Dose-intensified bendamustine followed by autologous peripheral blood stem cell support in relapsed and refractory multiple myeloma with impaired bone marrow function

• Verfasst von: Breitkreutz, Iris [VerfasserIn]
• Verfasst von: Kosely, Florentina [VerfasserIn]
• Verfasst von: Heining, Christoph [VerfasserIn]
• Verfasst von: Hillengaß, Jens [VerfasserIn]
• Verfasst von: Egerer, Gerlinde [VerfasserIn]
• Verfasst von: Ho, Anthony Dick [VerfasserIn]
• Verfasst von: Goldschmidt, Hartmut [VerfasserIn]
• Verfasst von: Raab, Marc-Steffen [VerfasserIn]
• Titel: Dose-intensified bendamustine followed by autologous peripheral blood stem cell support in relapsed and refractory multiple myeloma with impaired bone marrow function
• Verf.angabe: Iris Breitkreutz, Natalia Becker, Axel. Benner, Florentina Kosely, Christoph Heining, Jens Hillengass, Gerlinde Egerer, Anthony D. Ho, Hartmut Goldschmidt, Marc S. Raab
• Jahr: 2016
• Umfang: 8 S.
• Fussnoten: First published: 18 March 2015 ; Gesehen am 06.10.2017
• Titel Quelle: Enthalten in: Hematological oncology
• Ort Quelle: New York, NY [u.a.] : Wiley Interscience, 1983
• Jahr Quelle: 2016
• Band/Heft Quelle: 34(2016), 4, Seite 200-207
• ISSN Quelle: 1099-1069
• DOI: doi:10.1002/hon.2199
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: autologous blood stem cells
• Sach-SW: bendamustine
• Sach-SW: bone marrow function
• Sach-SW: multiple myeloma
• K10plus-PPN: 1564160270

Abstract

Therapeutic options in heavily pretreated relapsed/refractory multiple myeloma patients are often very limited because of impaired bone marrow function. Bendamustine is effective in multiple myeloma and has a favourable toxicity profile. We hypothesized that dose-intensified bendamustine (180 mg/m2, day 1 and 2) followed by autologous blood stem cell support (ASCS) would improve bone marrow function with low post-transplant toxicity in patients with severely impaired haematopoiesis. We analyzed 28 consecutive myeloma patients, with a median of three prior lines of therapy (range 2-7), who had relapsed from the last treatment with very limited bone marrow function and were therefore ineligible for conventional chemotherapy, novel agents or trial enrolment. Dose-intensified bendamustine with ASCS improved haematopoiesis as reflected by increased platelet counts (median 40/nl vs 94/nl, p = 0.0004) and white blood cell counts (3.0/nl vs 4.8/nl, p = 0.02) at day +100. The median time until engraftment of platelets (>50/nl) was 11 days (0-24 days) and of white cell counts (>1.0/nl) 0 days (0-24 days). At least, a minimal response was achieved in 36% of patients. The disease stabilization rate was 50% while the median progression-free survival rate was limited to 2.14 months. Most importantly, patients were once again eligible for alternative treatments including enrolment into clinical trials. We conclude that dose-intensified bendamustine followed by ASCS is safe and feasible for multiple myeloma patients with very limited bone marrow reserve. Copyright © 2015 John Wiley & Sons, Ltd.