In cases of progression, lenalidomide and carfilzomib usually. Mucositis is the most common complication of chemotherapeutics agents. Bc cancer protocol summary for the treatment of multiple myeloma. Alkeran for injection is supplied as a sterile, nonpyrogenic, freezedried powder. Melphalan, a bifunctional nitrogen mustardderivative alkylating agent, is the lisomer of mechlorethamine. Labardini mendez, eduardo cervera ceballos, carmen corrales alfaro, micaela balbuena martinez, arlette araceli barbosa ibarra, jose ramiro espinoza zamora, omar genaro lopez navarro, cristal medina perez, juan ojeda tovar, ana florencia ramirez ibarguen, silvia rivas vera, sergio arturo sanchez guerrero. Revlimid en mantenimiento en mieloma multiple aemps. Intermediatedose melphalan compared with myeloablative treatment in multiple myeloma. Prognostic factors with highdose melphalan for refractory multiple. If after 6 weeks anc is still less than 1 or platelets less than 100, reduce dose of melphalan to 75 %. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Melphalan is practically insoluble in water and has a pka.
Melphalanprednisonelenalidomide mpr versus highdose melphalan and. Multiple myeloma multiple myeloma is the second most common hematological malignancy. Bc cancer protocol summary for the treatment of multiple. Melphalan, a chemotherapy agent belonging to the drug class of alkylating agents, is a very effective treatment for myeloma, but it can also permanently damage normal blood stem cells. Alternating combination chemotherapy vmcpvbap vs melphalanprednisone in the treatment of multiple myeloma. Highdose melphalan is known as myeloablative therapy. Patient can develop gastrointestinal ulcers, vomiting and diarrhea with the use of high dose melphalan as a conditioning regimen for autologous transplant for multiple myeloma35.
High dose melphalan with autologous bone marrow transplanation for multiple myeloma article pdf available in blood 675. Each singleuse vial contains melphalan hydrochloride equivalent to 50 mg melphalan and 20 mg povidone. Longterm followup of the dutch cooperative group hovon 24 trial. Severe bone marrow suppression with resulting infection or bleeding may occur. Bortezomib, lenalidomide, multiple myeloma, dexamethasone, autologous stem cell transplantation. Previously untreated multiple myeloma or light al chain amyloidosis patients who are unsuitable for stem. Bortezomib plus melphalan and prednisone for initial treatment of multiple myeloma. This means they treat the tumor without affecting the rest of the body. Melphalan produces chromosomal aberrations in vitro and in vivo and, therefore, should.
Melphalan when used in high doses for treatment for multiple myeloma can lead to severe mucositis1,2. Original article from the new england journal of medicine bortezomib plus melphalan and prednisone for initial treatment of multiple myeloma. Alkeran melphalan is a drug prescribed for the treatment of multiple myeloma and ovarian cancer. High dosages of melphalan can be especially helpful in eradicating myeloma cells from the bone marrow.
Dosis melfalan hdm gevolgd door een autologe stamceltransplantatie. Clinical pharmacology food and drug administration. Multiple myeloma is the second most common hematological malignancy. Facon t, mary jy, hulin c, benboubker l, attal m, pegourie b, et al. Feb 07, 20 melphalan when used in high doses for treatment for multiple myeloma can lead to severe mucositis1,2. Nov 27, 2019 along with their needed effects, medicines like melphalan can sometimes cause unwanted effects such as blood problems and other side effects. Multiple myeloma is a disease diagnosed with increasing frequency. Asct and highdose melphalan in multiple myeloma the. Frontline treatment for multiple myeloma with rvd regimen bortezomib, lenalidomide and dexamethasone for transplanteligible and. Melphalan inhibits dna and rna synthesis via formation of interstrand cross links with dna, likely binding at the n. These treatments are more likely to be useful for earlier stage less advanced cancers, although they might also be used in some other situations.
June, 2011 london, united kingdom contrary to expectation, progressionfree survival in patients with multiple myeloma is longer in patients who receive highdose melphalan alkeran. Autologous hematopoietic cell transplantation in multiple mieloma. Side effects of alkeran melphalan, warnings, uses rxlist. Alkeran melphalan should be administered under the supervision of a qualified physician experienced in the use of cancer chemotherapeutic agents. Melphalan and dexamethasone for patients with multiple myeloma who are not candidates for autologous stem cell transplantation. Pdf high dose melphalan with autologous bone marrow. University of groningen clinical and biological aspects of multiple. Mieloma multiple diagnostico, estudio y tratamiento autores dr. Combination chemotherapy versus melphalan and prednisolone in the treatment of multiple myeloma. May 21, 2019 alkeran melphalan is a drug prescribed for the treatment of multiple myeloma and ovarian cancer. Intermediate doses of melphalan than dexamethasone are better than vad chemotherapy for.
Melphalan and dexamethasone for patients with multiple. Alkeran for injection is reconstituted using the sterile diluent provided. Mieloma multiple diagnostico, estudio y tratamiento. Understanding highdose therapy with stem cell rescue. Mieloma multiple tratamiento free download pdf ebook.
Medicamento dosis dias administracion bortezomib 1,3 mgm2dia 1, 4, 8 y 11 intravenosa directa, en 3 5 segundos. Multiple myeloma using melphalan, prednisone and weekly bortezomib with the. Sharma a1, lokeshwar n, raina v, mohanti bk, kumar r. Melphalan and prednisone plus thalidomide versus melphalan and prednisone alone or reducedintensity autologous stem cell transplantation in elderly patients with multiple myeloma ifm 9906. Acerca del mieloma multiple american cancer society. It is defined by the presence of monoclonal plasma cells capable to produce a monoclonal paraprotein causing clinical abnormalities such as anemia, renal insufficiency, hypercalcemia, or bone lesions. Autologous stemcell transplantation asct plus highdose melphalan has better outcome than conventional chemotherapy in newly diagnosed patients with multiple myeloma who were 65 years old or younger, according to a new study. Mieloma multiple melfalan, prednisona y lenalidomida en. Also, because of the way these medicines act on the body, there is a chance that they might cause other unwanted effects that may not occur until months or years. Melphalan iv multiple myeloma, al amyloidosis melphalan iv necn protocol crp08 h032 date issued. Data sources include ibm watson micromedex updated 28 feb 2020, cerner multum updated 2 mar 2020. Bortezomib plus melphalan and prednisone for initial.
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