Re-use of the original infusional induction chemotherapy as salvage therapy in myeloma patients relapsing after one autograft

Bhawna Sirohi, Ray Powles*, Claudius Rudin, Seema Singhal, Samar Kulkarni, Radovan Saso, Clive Horton, Jayesh Mehta, Jennifer Treleaven

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

If standard infusional therapy (IC) has been used to treat myeloma at presentation, it is a matter of debate whether patients should receive the original induction therapy or a different drug combination in first relapse. Instinctively, most clinicians may switch treatment, particularly since the advent of new drugs for the treatment of myeloma. Hitherto, there has been no data on the efficacy of repeating standard IC in the salvage setting. We studied 62 myeloma patients whose initial treatment consisted of C-VAMP and a single high dose melphalan procedure and who were retreated with C-VAMP at the time of first relapse. Response to salvage C-VAMP was seen in 50% (95% confidence interval = 0.37-0.62) but we were unable to identify any predictors for response to salvage C-VAMP. Only patients resistant to salvage C-VAMP benefited from a second autograft. The survival of patients who responded to salvage C-VAMP was not prolonged by a second transplant. In conclusion, our data supports the use of C-VAMP for patients with myeloma in first relapse and suggest that only patients resistant to salvage C-VAMP should be offered a second autograft.

Original languageEnglish (US)
Pages (from-to)361-364
Number of pages4
JournalHematology
Volume10
Issue number5
DOIs
StatePublished - Oct 2005

Keywords

  • C-VAMP
  • Myeloma
  • Relapse
  • Salvage therapy

ASJC Scopus subject areas

  • Hematology

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