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High-dose melphalan for multiple myeloma: long-term follow-up data
D Cunningham1, L Paz-Ares, M E Gore
1Cancer Research Center Section of Medicine, Royal Marsden Hospital, Sutton, Surrey, United Kingdom.
Summary
High-dose melphalan (HDM) without stem cell transplant offers a feasible treatment for multiple myeloma, achieving high response rates and long-term survival for some patients. This approach demonstrates good symptom control and quality of life improvements.
Area of Science:
- Hematology
- Oncology
- Clinical Medicine
Background:
- Multiple myeloma is a hematologic malignancy.
- High-dose melphalan (HDM) is a chemotherapy regimen used in cancer treatment.
- Autologous bone marrow transplantation is a common supportive care measure.
Purpose of the Study:
- To evaluate long-term outcomes for multiple myeloma patients treated with HDM.
- To identify prognostic factors influencing survival after HDM therapy.
Main Methods:
- A cohort of 63 previously untreated multiple myeloma patients received HDM (140 mg/m2).
- Treatment was administered without autologous bone marrow transplantation.
- Long-term follow-up data were collected and analyzed.
Main Results:
- An overall response rate of 82% was observed, with 32% achieving complete remission.
- Median response duration was 18 months; six patients had disease-free survival beyond 60 months.
- Median survival was 47 months, with 35% projected survival at 9 years; no late toxicities were noted.
Conclusions:
- Single-agent HDM is a viable treatment option for multiple myeloma.
- HDM therapy without transplantation yields high response rates and durable remissions.
- The treatment is associated with improved quality of life and symptom control.