Amifostine reduces mucosal damage after high-dose melphalan conditioning and autologous peripheral blood progenitor cell transplantation for patients with multiple myeloma

Bone Marrow Transplant. 2002 Dec;30(11):769-75. doi: 10.1038/sj.bmt.1703757.

Abstract

High-dose melphalan (HDM) has been adopted as standard therapy in the treatment of multiple myeloma. This treatment is associated with non-selective cytotoxicity, causing oral mucositis as the major non-hematological side-effect. Amifostine is a cytoprotector which prevents toxicity induced by anticancer therapy. We prospectively compared two groups of patients who either received (group A, n = 21) or did not receive (group B, n = 20) amifostine (740 mg/m(2)) before HDM (200 mg/m(2)) followed by autologous peripheral blood progenitor cell transplantation. The occurrence of severe oral mucositis was significantly decreased in group A in comparison to group B (33% vs 65%, P < 0.05). Six patients in group A required opioid analgesic therapy during a mean period of 4.8 days as compared to eight patients for 6.5 days in group B (P = NS). Delayed vomiting was less frequent in group A (43% vs 70%, P = 0.07) and significantly less severe in group A (grade 2-4) vomiting: two patients vs nine patients, P < 0.02). No difference was observed between the two groups in either hematological toxicity after HDM or in response rate. Grade I emesis was the only immediate side-effect observed after amifostine administration. We conclude that amifostine can reduce mucositis induced by HDM.

Publication types

  • Clinical Trial
  • Clinical Trial, Phase II
  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Amifostine / administration & dosage
  • Amifostine / pharmacology*
  • Amifostine / toxicity
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / toxicity*
  • Female
  • Graft Survival
  • Humans
  • Kinetics
  • Male
  • Melphalan / toxicity
  • Middle Aged
  • Mouth Mucosa / drug effects
  • Multiple Myeloma / complications
  • Multiple Myeloma / therapy*
  • Peripheral Blood Stem Cell Transplantation / adverse effects*
  • Peripheral Blood Stem Cell Transplantation / methods
  • Stomatitis / chemically induced*
  • Stomatitis / prevention & control
  • Transplantation Conditioning / adverse effects*
  • Transplantation, Autologous
  • Treatment Outcome

Substances

  • Amifostine
  • Melphalan