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Thiotepa, busulfan, and cyclophosphamide: a new preparative regimen for
autologous marrow or blood stem cell transplantation in high-risk multiple
myeloma
MA Dimopoulos, R Alexanian, D Przepiorka, J Hester, B Andersson, S Giralt, R Mehra, K van Besien, KB Delasalle and C Reading
Department of Hematology, University of Texas M.D. Anderson Cancer Center,
Houston.
Forty patients with multiple myeloma received thiotepa (750 mg/m2),
busulfan (10 mg/kg), and cyclophosphamide (120 mg/kg) (TBC) followed by
autologous bone marrow or blood stem cell support. Granulocyte-Colony
stimulating factor (G-CSF) was administered to accelerate hematopoietic
recovery. Sixty-five percent of all patients responded to this treatment.
Eighty-eight percent of patients transplanted in partial remission had a
further reduction of the myeloma and 53% achieved a complete remission.
Forty-eight percent of patients with refractory myeloma responded. All
responding patients transplanted during partial remission or with primary
refractory myeloma remain free of progression for a period of 4 to 24
months post-transplant, but the remission duration of patients treated in
refractory relapse was short (4 months). Five of 24 patients transplanted
with marrow and none of 16 receiving blood stem cells died of
treatment-related complications. Use of blood stem cells resulted in more
rapid granulocyte and platelet recovery. We conclude that TBC is an
effective, relatively well tolerated, preparative regimen for patients with
multiple myeloma.
Volume 82,
Issue 8,
pp. 2324-2328,
10/15/1993
Copyright © 1993 by The American Society of Hematology
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