A phase II study of V-BEAM as conditioning regimen before second auto-SCT for multiple myeloma

作者：Wang T F; Fiala M A; Cashen A F; Uy G L; Abboud C N; Fletcher T; Wu N; Westervelt P; DiPersio J F; Stockerl Goldstein K E; Vij R^*

来源：Bone Marrow Transplantation, 2014, 49(11): 1366-1370.

DOI：10.1038/bmt.2014.163

High-dose melphalan has been the standard conditioning regimen for auto-SCT in multiple myeloma (MM) for decades. A more effective conditioning regimen may induce deeper responses and longer remission duration. It is especially needed in the setting of second auto-SCT, which rarely achieves comparable results with the first auto-SCT using the same conditioning regimen. Here we conducted a phase II study to investigate the efficacy and safety of a conditioning regimen V-BEAM (bortezomib-BEAM) before second auto-SCT for multiple myeloma. Ten patients were enrolled from September 2012 to May 2013. The CR rate at day +100 after auto-SCT was 75%; all except for one patient remained in remission after a median follow-up of 6 months. Three patients developed Clostridium difficile infection. Two patients died within the first 30 days of auto-SCT from neutropenic colitis and overwhelming sepsis, respectively. Due to the high rate of morbidity and mortality, the study was terminated after 10 patients. In summary, although the conditioning regimen V-BEAM before second auto-SCT for MM provided promising responses, it was associated with unexpected treatment-related toxicity and should not be investigated further without modifications.

• 出版日期2014-11