[Effects of ifosfamide in combination with pegylated liposomal doxorubicin and dexamethasone in the treatment of relapsed/refractory multiple myeloma]

Zhonghua Yi Xue Za Zhi. 2016 Nov 29;96(44):3573-3576. doi: 10.3760/cma.j.issn.0376-2491.2016.44.008.
[Article in Chinese]

Abstract

Objective: To investigate the efficacy and adverse effects of ifosfamide in combination with pegylated liposomal doxorubicin and dexamethasone (CDD) in treating patients with relapsed/refractory multiple myeloma (MM). Methods: The clinical data of 30 relapsed/refractory MM patients treated with CDD regimen in Department of Hematology and Oncology of Beijing Chaoyang Hospital from November 2012 to November 2015 were retrospectively analyzed. The CDD treatment included ifosfamide 0.5-1.0 g/d on d1-4, pegylated liposomal doxorubicin 40-60 mg/d on d1, and dexamethasone 10-20 mg/d on d1-4. One cycle consisted of 21 or 28 days. Efficacy analysis was performed after every two cycles. Results: (1)The overall response rate (ORR) was 50.0% and the complete remission and near complete remission (CR+ nCR) rate was 10.0%. (2)The ORR of the 23 patients without extramedullary plasmacytoma(EMP)was 43.5% and the CR+ nCR rate was 8.7%. The ORR of the 7 patients with EMP was 5/7 and the CR+ nCR rate was 1/7. There were no statistically significant differences in ORR and CR+ nCR rate between the two groups (both P>0.05). (3)Except for the 5 patients with disease progression, the median progression-free survival (PFS) of the other 25 patients was 8.0 (3.0-25.0) months. The median PFS of the patients without EMP was 8.5 (3.0-25.0) months, that of the patients with EMP was 6.0 (2.0-21.0) months, with no statistically significant difference (P>0.05). The adverse effects included constipation, infection, hyperglycemia, and hemocytopenia, which were controlled by symptomatic treatment and did not affect the chemotherapy. Conclusion: CDD regimen can be used for the treatment of relapsed/refractory MM, especially in patients with EMP, with good efficacy and tolerance.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols
  • Dexamethasone
  • Disease Progression
  • Disease-Free Survival
  • Doxorubicin / analogs & derivatives
  • Female
  • Humans
  • Ifosfamide
  • Male
  • Middle Aged
  • Multiple Myeloma*
  • Polyethylene Glycols
  • Remission Induction
  • Retrospective Studies

Substances

  • liposomal doxorubicin
  • Polyethylene Glycols
  • Dexamethasone
  • Doxorubicin
  • Ifosfamide