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Related Experiment Video

Updated: Jul 8, 2025

Percutaneous Hepatic Perfusion PHP with Melphalan as a Treatment for Unresectable Metastases Confined to the Liver

Percutaneous Hepatic Perfusion PHP with Melphalan as a Treatment for Unresectable Metastases Confined to the Liver

Published on: July 31, 2016

Optimizing high dose melphalan.

Gunjan Shah¹, Sergio Giralt¹, Parastoo Dahi¹

¹Adult BMT Service Memorial Sloan Kettering Cancer Center, 530 East 74th Street, New York, NY 10021, United States of America.

|December 14, 2023

Summary

High-dose melphalan (HDM) is key for multiple myeloma HCT. Strategies are explored to improve HDM efficacy and reduce toxicities like myelosuppression and mucositis for better patient outcomes.

Keywords:

Autologous stem cell transplantation High dose therapy Melphalan Myeloma

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Published on: July 31, 2016

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Minimally Invasive Isolated Limb Perfusion (MI-ILP) for Locally Advanced Melanomas and Sarcomas of the Extremity

Minimally Invasive Isolated Limb Perfusion (MI-ILP) for Locally Advanced Melanomas and Sarcomas of the Extremity

Published on: January 31, 2025

Area of Science:

Hematology
Oncology
Pharmacology

Background:

High-dose melphalan (HDM) is a cornerstone of conditioning regimens for autologous hematopoietic cell transplantation (HCT) in multiple myeloma.
Despite its efficacy, HDM is associated with significant toxicities, including myelosuppression, gastrointestinal issues, and mucositis.

Purpose of the Study:

To review current strategies for enhancing the efficacy of HDM in multiple myeloma treatment.
To explore methods for mitigating HDM-related toxicities in patients undergoing HCT.

Main Methods:

Review of established and emerging approaches to manage HDM toxicity, such as dose modification, antiemetics, cryotherapy, amifostine, and growth factors.
Discussion of novel strategies including personalized dosing, combination therapies (e.g., with busulfan, bendamustine), and new formulations like propylene glycol-free melphalan (Evomela).

Main Results:

Established methods effectively manage common HDM toxicities.
Personalized dosing, combination therapies, and novel formulations show promise for optimizing melphalan exposure and reducing adverse effects.

Conclusions:

Multiple strategies exist to improve the therapeutic index of HDM in multiple myeloma HCT.
Further clinical trials are needed to validate these strategies, aiming to enhance safety and efficacy for improved patient outcomes.