Abstract
A retrospective case-matched study was conducted to compare the oral regimen CTD (cyclophosphamide - thalidomide - dexamethasone) and infusional CVAMP (cyclophosphamide - vincristine - doxorubicin - methylprednisolone) as induction therapy followed by autologous peripheral blood stem-cell transplantation (PBSCT) for newly diagnosed multiple myeloma patients. The response rate after three cycles of treatment was statistically higher with CTD (n = 27) compared to CVAMP (n = 27) (89% vs. 56%, P = 0.016). Toxicity studies showed more neutropenia (grade 3/4) (4% vs. 60%, P = 0.0002) with CVAMP and more thrombotic episodes with CTD (11% vs. 4%). CTD may emerge as the superior induction regimen prior to PBSCT, in terms of high efficacy and better tolerability.
MeSH terms
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Adult
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Aged
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Antineoplastic Agents / adverse effects
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Antineoplastic Agents / therapeutic use*
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Case-Control Studies
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Cyclophosphamide / adverse effects
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Cyclophosphamide / therapeutic use
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Dexamethasone / therapeutic use
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Doxorubicin / adverse effects
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Doxorubicin / therapeutic use
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Drug Therapy, Combination
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Female
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Humans
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Male
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Methylprednisolone / adverse effects
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Methylprednisolone / therapeutic use
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Middle Aged
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Multiple Myeloma / drug therapy*
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Multiple Myeloma / epidemiology*
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Multiple Myeloma / pathology
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Multiple Myeloma / surgery
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Peripheral Blood Stem Cell Transplantation*
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Thalidomide / therapeutic use
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Transplantation, Autologous
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Vincristine / adverse effects
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Vincristine / therapeutic use
Substances
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Antineoplastic Agents
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Thalidomide
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Vincristine
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Dexamethasone
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Doxorubicin
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Cyclophosphamide
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Methylprednisolone