The combination of cyclophosphomide, thalidomide and dexamethasone is an effective alternative to cyclophosphamide - vincristine - doxorubicin - methylprednisolone as induction chemotherapy prior to autologous transplantation for multiple myeloma: a case-matched analysis

Leuk Lymphoma. 2006 Nov;47(11):2335-8. doi: 10.1080/10428190600821955.

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

  • Adult
  • Aged
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use*
  • Case-Control Studies
  • Cyclophosphamide / adverse effects
  • Cyclophosphamide / therapeutic use
  • Dexamethasone / therapeutic use
  • Doxorubicin / adverse effects
  • Doxorubicin / therapeutic use
  • Drug Therapy, Combination
  • Female
  • Humans
  • Male
  • Methylprednisolone / adverse effects
  • Methylprednisolone / therapeutic use
  • Middle Aged
  • Multiple Myeloma / drug therapy*
  • Multiple Myeloma / epidemiology*
  • Multiple Myeloma / pathology
  • Multiple Myeloma / surgery
  • Peripheral Blood Stem Cell Transplantation*
  • Thalidomide / therapeutic use
  • Transplantation, Autologous
  • Vincristine / adverse effects
  • Vincristine / therapeutic use

Substances

  • Antineoplastic Agents
  • Thalidomide
  • Vincristine
  • Dexamethasone
  • Doxorubicin
  • Cyclophosphamide
  • Methylprednisolone