Abstract
High-dose melphalan (HDM) followed by autologous hematopoietic cell transplantation (auto-HCT) remains the standard-of-care therapy for multiple myeloma (MM) even with the availability of proteasome inhibitors and immunomodulatory drugs. Gastrointestinal (GI) toxicity is the main cause of morbidity after HDM. Amifostine, a cytoprotective agent, may reduce HDM-associated GI toxicity. We conducted a case control study comparing HDM + auto-HCT with or without amifostine for MM patients. One hundred and seven patients treated at University Hospitals Cleveland Medical Center who received pre-transplant amifostine were compared to 114 patients treated at MD Anderson Cancer Center without use of this agent. Amifostine 740 mg/m2 was administered as a bolus infusion at 24 h and 15 min before HDM. Patients’ characteristics were similar in both the groups. Amifostine therapy was well tolerated without any significant adverse effects. Grade II or greater oral mucositis (27.1% vs 47.4%; p =.002), nausea (31.8% vs. 86.0%; p =.0001), vomiting (18.7% vs. 52.6%; p =.0001) and diarrhea (56.1% vs. 72.7%; p =.006) occurred less frequently in the amifostine-treated group. There was no discernable effect of amifostine on engraftment, progression-free or overall survival. Our results indicate that amifostine decreases GI toxicity while preserving anti-myeloma efficacy of HDM and auto-HCT.
Original language | English (US) |
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Pages (from-to) | 1905-1912 |
Number of pages | 8 |
Journal | Leukemia and Lymphoma |
Volume | 59 |
Issue number | 8 |
DOIs | |
State | Published - Aug 3 2018 |
Keywords
- Multiple myeloma
- amifostine
- autologous stem cell transplant
ASJC Scopus subject areas
- Hematology
- Oncology
- Cancer Research