Результаты поиска

Induction bortezomib in Al amyloidosis followed by high dose melphalan and autologous stem cell transplantation: a single institution retrospective study.

INTRODUCTION/BACKGROUND: High-dose melphalan (HDM) followed by autologous stem cell transplant (ASCT) for light chain amyloidosis (AL) was performed in 31 patients at Oregon Health and Science University between 2005 and 2012. Fifteen patients had cardiac involvement. PATIENTS AND METHODS: Patients received melphalan 200 mg/m(2) or dose-adjusted HDM (100-140 mg/m(2)) depending on high risk features. Thirteen patients proceeded directly to ASCT after diagnosis, 12 patients received a bortezomib-containing regimen, and 6 received a variety of other induction regimens. RESULTS: The day 100 trea…

[Kappa light chain deposition disease, presenting as Sjögren's syndrome, successfully treated by high-dose melphalan and autologous blood stem transplantation].

INTRODUCTION: Light chain deposition disease is a systemic disorder characterised by tissue deposition of monoclonal immunoglobulin light chains without tinctorial properties. It has been exceptionally reported with salivary involvement mimicking Sjögren's syndrome and peripheral neuropathy. CASE REPORT: We report a case of light chain deposition disease associated with plasma cell dyscrasia presenting as sicca syndrome with salivary glands hypertrophy and polyneuropathy successfully treated by high dose melphalan and autologous blood stem transplantation. CONCLUSION: Light chain deposition …

[Pyoderma gangrenosum, ovarian carcinoma treated with Melphalan and acute myelomonocytic leukaemia: report of one case and literature review (author's transl)].

A 67-year-old woman suffered from an ovarian carcinoma with lymph nodes metastasis. During 3 years, she was treated with alkylating agents (Melphalan). At the end of therapy, no recurrence was observed. Two years later, she developed concomitantly pyoderma gangrenosum and acute myelomonocytic leukaemia. Death occurred rapidly. The association between pyoderma gangrenosum and acute leukaemia is discussed in the light of 16 cases previously reported in the literature. In this case, an induction of leukaemia by cytostatic drugs seems likely. The authors conclude that pyoderma gangrenosum may be c…

Comparative Evaluation of Single-Dose and Split-Dose Melphalan Conditioning Concerning Toxicity Profiles and Engraftment Kinetics: A Propensity Score-Matched Analysis.

High-dose melphalan (HDM) remains the gold-standard conditioning regimen for autologous stem cell transplantation (ASCT) in multiple myeloma (MM), significantly improving response depth and long-term survival. However, HDM is associated with substantial toxicities, notably oral mucositis and gastrointestinal complications. To mitigate these, centers vary the administration schedule between a single bolus (200 mg/m²) or a split-dose approach over 2 days. Existing literature comparing these methods is limited and inconsistent regarding both toxicity and engraftment kinetics. This study compares …

Salvage UCBT with Short-Term Melphalan-based Reduced-Intensity Conditioning for Primary Graft Failure after Upfront UCBT for Fulminant Aplastic Anemia.

Umbilical cord blood transplantation (UCBT) is a potential option for patients with very severe aplastic anemia (VSAA) when no suitable related or unrelated donor is available. However, the high incidence of graft failure following UCBT remains a major challenge. The optimal conditioning regimen for UCBT in aplastic anemia (AA), particularly for salvage UCBT after graft failure following an initial transplant, remains undetermined. We report the cases of two adolescent patients with fulminant aplastic anemia who successfully underwent salvage UCBT, conditioned by a short-term melphalan-based r…

Эффективность интенсивной антиэпидемиологической терапии, включая оланзапин у нескольких пациентов миэломы, лечившихся высокодозированными мелфаланами с аутологической трансплантацией стволовых клеток.

ЦЕЛЬ: Кондиционирование с использованием высокодозированного мелфалана (MEL), за которым следует аутологическая трансплантация стволовых клеток (ASCT), является стандартным методом лечения множественной миеломы (MM). Оптимальный режим предотвращения тошноты и рвоты, вызванных химиотерапией, не ясен. Мы стремились ретроспективно оценить антиеметический эффект и безопасность four- интенсивный наркологический режим, включая оланзапин (ОЛА) на CINV у пациентов MM, получающих MEL/ASCT. МЕТОДЫ: МЕЛ200 мг/м2) в дневное время 1, за которым следует ASCT в день 3. Пациенты были отнесены к стандартной гр

Совпадение в аннотации оригинала
PURPOSE: Conditioning with high-dose melphalan (MEL) followed by autologous stem cell transplantation (ASCT) is the standard treatment for multiple myeloma (MM). The optimal regimen to prevent chemotherapy-induced nausea and vomiting (CINV) is unclear. We aimed to retrospectively evaluate the antiemetic effect and safety of a four-drug intensive regimen incl…

[Allogeneic hematopoietic stem cell transplantation with high-dose melphalan and total body irradiation for hematological malignancies: a single-center retrospective analysis].

We retrospectively analyzed outcomes for 12 patients with hematopoietic malignancies who underwent allogeneic stem cell transplantation between January 2005 and December 2023 using a myeloablative conditioning regimen with melphalan (180 mg/m2) and total body irradiation (8-12 Gy). Median age at transplantation was 41.5 years (range, 17-51 years) and underlying diagnoses were acute myeloid leukemia (n=5), acute lymphoblastic leukemia (n=5), myelodysplastic syndrome (n=1), and adult T-cell leukemia/lymphoma (n=1). Median follow-up was 32 months (range, 1-190 months). Neutrophil engraftment was …

Characteristics of oral mucositis in patients undergoing haploidentical stem cell transplantation with posttransplant cyclophosphamide: marked difference between busulfan and melphalan regimens.

PURPOSE: This study was performed to examine the effects of conditioning regimens on oral mucositis in haploidentical (haplo) donor hematopoietic stem cell transplantation (HSCT) with posttransplant cyclophosphamide (PTCy). METHODS: Thirty consecutive patients (male, 23; female, 7; 18-68 years, median, 59 years) undergoing haplo-HSCT with PTCy using one of three conditioning regimens-reduced intensity conditioning (RIC)-melphalan (Mel); RIC-Busulfan (Bu); and myeloablative conditioning (MAC)-Bu-were enrolled in this study. Data on the WHO grade of oral mucositis (day - 7 to + 20) were collect…

Long-Term Follow-Up of Multiple Myeloma Patients Treated with Tandem Autologous Transplantation Following Melphalan and Upon Recovery, Total Marrow Irradiation.

Total body irradiation in combination with melphalan for multiple myeloma (MM) has been shown to be prohibitively toxic. To ameliorate toxicity, total marrow irradiation (TMI) has been administered as the sole ablative modality during the second cycle of tandem autologous stem cell transplantation (TASCT) for MM patients on a phase I-II trial. Patients with MM in response or with stable disease and ≤18 months from diagnosis received melphalan 200 mg/m2 and autologous stem cell transplantation (ASCT) (cycle 1) and then, after recovery, TMI and another ASCT (cycle 2), followed by maintenance wit…

Long-Term Remission of Acquired Von-Willebrand's Disease and Platelet Dysfunction after High-Dose Melphalan in a Patient with Multiple Myeloma.

Background: Autologous stem cell transplantation is considered a standard of care treatment in eligible patients with multiple myeloma, but … lobulins, whereas replacement of plasma-derived VW factor showed no clinical improvement. High-dose melphalan-based consolidation therapy supported with autologous stem-cell transplantation led to an immediate and sustainable rise of von-Willebrand antigen and activity and a subsequent normalization of platelet aggregation activity. After a follow-up of 40 …

Overall survival with daratumumab, bortezomib, melphalan, and prednisone in newly diagnosed multiple myeloma (ALCYONE): a randomised, open-label, phase 3 trial.

BACKGROUND: Standard-of-care treatment for patients with newly diagnosed multiple myeloma includes combination therapies for patients who are not eligible for autologous stem-cell transplantation. At the primary analysis for progression-free survival of the phase 3 ALCYONE trial, progression-free survival was significantly longer with daratumumab in combination with bortezomib, melphalan, and prednisone (D-VMP) versus bortezomib, melphalan, and prednisone (VMP) alone in patients with transplant-ineligible, newly diagnosed multiple myeloma. Here we report updated efficacy and safety results fro…

Molecular Characteristics of High-Dose Melphalan Associated Oral Mucositis in Patients with Multiple Myeloma: A Gene Expression Study on Human Mucosa.

BACKGROUND: Toxicity of the oral and gastrointestinal mucosa induced by high-dose melphalan is a clinical challenge with no documented prophylactic interventions or predictive tests. The aim of this study was to describe molecular changes in human oral mucosa and to identify biomarkers correlated with the grade of clinical mucositis. METHODS AND FINDINGS: Ten patients with multiple myeloma (MM) were included. For each patient, we acquired three buccal biopsies, one before, one at 2 days, and one at 20 days after high-dose melphalan administration. We also acquired buccal biopsies from 10 heal…

Bortezomib, dexamethasone, and high-dose melphalan as conditioning for stem cell transplantation in young Japanese multiple myeloma patients: a pilot study.

Autologous stem cell transplantation is recommended for younger patients with newly diagnosed multiple myeloma because of a high complete response rate and better survival. Bortezomib shows a synergistic effect with melphalan and has no prolonged hematologic toxicity, and the complete response rate after autologous stem cell transplantation is improved by combining bortezomib with melphalan for conditioning. Twelve patients were enrolled in a phase 2 study between February and November 2010, receiving bortezomib (1 mg/m(2) × 4), dexamethasone (20 mg/body × 8), and melphalan (200 mg/m(2)) for c…

Microbiologically documented infections in patients undergoing high-dose melphalan and autologous stem cell transplantation for the treatment of light chain amyloidosis.

BACKGROUND: Immunoglobulin light chain (AL) amyloidosis can be treated with high-dose melphalan and autologous stem cell transplantation (HDM/SCT). Risk factors for infections may include hyposplenism, hypogammaglobulinemia, treatment-related neutropenia, melphalan-induced mucositis, and nosocomial exposures. METHODS AND DESIGN: A review of 493 patients with AL amyloidosis undergoing treatment with HDM/SCT from August 1994 to August 2009 was performed. The objectives were to determine the rate and types of infections following HDM/SCT, to identify factors associated with microbiologically doc…

[High-dose melphalan with stem cell support is now an established myeloma therapy. Treatment of myeloma from a 30-year perspective].

Melphalan and prednisone have been the backbone in myeloma therapy for more than 40 years. New developments in chemotherapy and supportive therapy, achieved during the two decades which preceded the use of high-dose chemotherapy with stem cell rescue, have not changed the overall prognosis. A study of high-dose melphalan with autologous stem cell support on 274 patients < 60 years, performed by the Nordic Myeloma Study Group, has shown a prolongation of the median survival by 1.5 years. The results confirm that this therapy is a major step forward in myeloma therapy. Cost-utility and quality-o…

Dose-intensive melphalan with blood stem cell support for the treatment of AL amyloidosis: one-year follow-up in five patients.

The morbidity and lethality of AL amyloidosis is caused by the deposition of lg light chains as fibrillar amyloid protein in vital organs, disrupting their function, and not by the generally low burden of clonal plasma cells that produce the paraproteins. Survival of patients with AL amyloidosis is no more than 1 to 2 years from the time of diagnosis with current management approaches. Clearly, more effective therapies are needed for this rapidly lethal disease. Five patients were treated with dose-intensive melphalan and blood stem cell support and followed for a period of 1 year. Patients we…

An Open-label, Randomized Study of Melphalan/Hepatic Delivery System Versus Best Alternative Care in Patients with Unresectable Metastatic Uveal Melanoma.

BACKGROUND: Metastatic uveal melanoma (mUM) has a poor prognosis, with liver metastases typically presenting a therapeutic challenge. Melphalan/Hepatic Delivery System (Melphalan/HDS) is a drug/medical device combination used for liver-directed treatment of unresectable mUM patients. This study assessed efficacy and safety of Melphalan/HDS versus best alternative care (BAC). METHODS: Eligible patients with unresectable mUM were randomized (1:1) to receive Melphalan/HDS (3 mg/kg ideal body weight) once every 6 to 8 weeks for a maximum of 6 cycles or BAC. Due to slow enrollment and patient relu…