Tags

Type your tag names separated by a space and hit enter

Induction therapy with vincristine, adriamycin, dexamethasone (VAD) and intermediate-dose melphalan (IDM) followed by autologous or allogeneic stem cell transplantation in newly diagnosed multiple myeloma.
Bone Marrow Transplant. 1999 Feb; 23(4):317-22.BM

Abstract

We performed a phase II study to test the efficacy and feasibility of induction therapy with vincristine, adriamycin and dexamethasone (VAD) and intermediate-dose melphalan, 70 mg/m2 (IDM), to autologous or allogeneic stem cell transplantation in newly diagnosed multiple myeloma (MM). A total of 77 patients received two cycles of VAD (n = 62) and/or two cycles of i.v. IDM 70 mg/m2 (n = 15) combined with G-CSF. PBSC were harvested after the first IDM, successfully in 87% of patients. Patients with a response to induction received myeloablative therapy with PBSCT (n = 50) followed by IFN maintenance or allo-BMT (n = 11). Seventy-two per cent of patients achieved a response after VAD which increased to 85% after IDM. Of patients who received PBSCT and allo-BMT, 24% and 45% achieved CR, respectively. Toxicity of induction consisted mainly of bone marrow suppression after IDM (median 8 days) with prolonged aplasia in 11% of patients after the second IDM. Only six infections WHO grade 3 occurred during induction. Treatment-related mortality of PBSCT and allo-BMT was 6% and 18%, respectively. Median time of follow-up is 44 months, and 50% of patients after PBSCT and 60% of patients after allo-BMT are still in remission. Survival rates of all patients were 82%, 75% and 63%, and for transplanted patients 86%, 79% and 68% after 12, 24 and 36 months. Well known prognostic factors, including alpha-IFN maintenance after PBSCT, were not significant for response or survival although patients in CR after allo-BMT had a strong tendency for better outcome. VAD/IDM is an effective and safe induction therapy for autologous and allogeneic stem cell transplantation. Based on these observations a phase III trial was started in October 1995 comparing IFN maintenance with PBSCT and allo-BMT after response to induction with VAD and IDM.

Authors+Show Affiliations

Department of Hematology, University Hospital Utrecht, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Clinical Trial, Phase II
Journal Article

Language

eng

PubMed ID

10100574

Citation

Lokhorst, H M., et al. "Induction Therapy With Vincristine, Adriamycin, Dexamethasone (VAD) and Intermediate-dose Melphalan (IDM) Followed By Autologous or Allogeneic Stem Cell Transplantation in Newly Diagnosed Multiple Myeloma." Bone Marrow Transplantation, vol. 23, no. 4, 1999, pp. 317-22.
Lokhorst HM, Sonneveld P, Cornelissen JJ, et al. Induction therapy with vincristine, adriamycin, dexamethasone (VAD) and intermediate-dose melphalan (IDM) followed by autologous or allogeneic stem cell transplantation in newly diagnosed multiple myeloma. Bone Marrow Transplant. 1999;23(4):317-22.
Lokhorst, H. M., Sonneveld, P., Cornelissen, J. J., Joosten, P., van Marwijk Kooy, M., Meinema, J., Nieuwenhuis, H. K., van Oers, M. H., Richel, D. J., Segeren, C. N., Veth, G., Verdonck, L. F., & Wijermans, P. W. (1999). Induction therapy with vincristine, adriamycin, dexamethasone (VAD) and intermediate-dose melphalan (IDM) followed by autologous or allogeneic stem cell transplantation in newly diagnosed multiple myeloma. Bone Marrow Transplantation, 23(4), 317-22.
Lokhorst HM, et al. Induction Therapy With Vincristine, Adriamycin, Dexamethasone (VAD) and Intermediate-dose Melphalan (IDM) Followed By Autologous or Allogeneic Stem Cell Transplantation in Newly Diagnosed Multiple Myeloma. Bone Marrow Transplant. 1999;23(4):317-22. PubMed PMID: 10100574.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Induction therapy with vincristine, adriamycin, dexamethasone (VAD) and intermediate-dose melphalan (IDM) followed by autologous or allogeneic stem cell transplantation in newly diagnosed multiple myeloma. AU - Lokhorst,H M, AU - Sonneveld,P, AU - Cornelissen,J J, AU - Joosten,P, AU - van Marwijk Kooy,M, AU - Meinema,J, AU - Nieuwenhuis,H K, AU - van Oers,M H, AU - Richel,D J, AU - Segeren,C N, AU - Veth,G, AU - Verdonck,L F, AU - Wijermans,P W, PY - 1999/4/1/pubmed PY - 1999/4/1/medline PY - 1999/4/1/entrez SP - 317 EP - 22 JF - Bone marrow transplantation JO - Bone Marrow Transplant VL - 23 IS - 4 N2 - We performed a phase II study to test the efficacy and feasibility of induction therapy with vincristine, adriamycin and dexamethasone (VAD) and intermediate-dose melphalan, 70 mg/m2 (IDM), to autologous or allogeneic stem cell transplantation in newly diagnosed multiple myeloma (MM). A total of 77 patients received two cycles of VAD (n = 62) and/or two cycles of i.v. IDM 70 mg/m2 (n = 15) combined with G-CSF. PBSC were harvested after the first IDM, successfully in 87% of patients. Patients with a response to induction received myeloablative therapy with PBSCT (n = 50) followed by IFN maintenance or allo-BMT (n = 11). Seventy-two per cent of patients achieved a response after VAD which increased to 85% after IDM. Of patients who received PBSCT and allo-BMT, 24% and 45% achieved CR, respectively. Toxicity of induction consisted mainly of bone marrow suppression after IDM (median 8 days) with prolonged aplasia in 11% of patients after the second IDM. Only six infections WHO grade 3 occurred during induction. Treatment-related mortality of PBSCT and allo-BMT was 6% and 18%, respectively. Median time of follow-up is 44 months, and 50% of patients after PBSCT and 60% of patients after allo-BMT are still in remission. Survival rates of all patients were 82%, 75% and 63%, and for transplanted patients 86%, 79% and 68% after 12, 24 and 36 months. Well known prognostic factors, including alpha-IFN maintenance after PBSCT, were not significant for response or survival although patients in CR after allo-BMT had a strong tendency for better outcome. VAD/IDM is an effective and safe induction therapy for autologous and allogeneic stem cell transplantation. Based on these observations a phase III trial was started in October 1995 comparing IFN maintenance with PBSCT and allo-BMT after response to induction with VAD and IDM. SN - 0268-3369 UR - https://www.unboundmedicine.com/medline/citation/10100574/Induction_therapy_with_vincristine_adriamycin_dexamethasone__VAD__and_intermediate_dose_melphalan__IDM__followed_by_autologous_or_allogeneic_stem_cell_transplantation_in_newly_diagnosed_multiple_myeloma_ L2 - https://doi.org/10.1038/sj.bmt.1701574 DB - PRIME DP - Unbound Medicine ER -