Original Article
Effect of time to infusion of autologous stem cells (24 vs. 48 h) after high-dose melphalan in patients with multiple myeloma
Giampaolo Talamo,
Kevin L. Rakszawski,
Witold B. Rybka,
Nathan G. Dolloff,
Jozef Malysz,
Tamara Berno,
Maurizio Zangari,
Corresponding Author
Giampaolo Talamo
Penn State Milton S. Hershey Cancer Institute, Hershey, PA, USA
GiampaoloTalamo, MD, Associate Professor, Penn State Milton S. Hershey Cancer Institute, 500 University Drive, Hershey, PA 17033-0850, USA. Tel: +1 717 531 8678; Fax: +1 717 531 5076; e-mail: [email protected]Search for more papers by this authorKevin L. Rakszawski
Penn State Milton S. Hershey Cancer Institute, Hershey, PA, USA
Search for more papers by this authorWitold B. Rybka
Penn State Milton S. Hershey Cancer Institute, Hershey, PA, USA
Search for more papers by this authorNathan G. Dolloff
Penn State Milton S. Hershey Cancer Institute, Hershey, PA, USA
Search for more papers by this authorJozef Malysz
Penn State Milton S. Hershey Cancer Institute, Hershey, PA, USA
Search for more papers by this authorTamara Berno
Blood/Marrow and Myeloma Program, University of Utah, Salt Lake City, UT, USA
Search for more papers by this authorMaurizio Zangari
Blood/Marrow and Myeloma Program, University of Utah, Salt Lake City, UT, USA
Search for more papers by this authorGiampaolo Talamo,
Kevin L. Rakszawski,
Witold B. Rybka,
Nathan G. Dolloff,
Jozef Malysz,
Tamara Berno,
Maurizio Zangari,
Corresponding Author
Giampaolo Talamo
Penn State Milton S. Hershey Cancer Institute, Hershey, PA, USA
GiampaoloTalamo, MD, Associate Professor, Penn State Milton S. Hershey Cancer Institute, 500 University Drive, Hershey, PA 17033-0850, USA. Tel: +1 717 531 8678; Fax: +1 717 531 5076; e-mail: [email protected]Search for more papers by this authorKevin L. Rakszawski
Penn State Milton S. Hershey Cancer Institute, Hershey, PA, USA
Search for more papers by this authorWitold B. Rybka
Penn State Milton S. Hershey Cancer Institute, Hershey, PA, USA
Search for more papers by this authorNathan G. Dolloff
Penn State Milton S. Hershey Cancer Institute, Hershey, PA, USA
Search for more papers by this authorJozef Malysz
Penn State Milton S. Hershey Cancer Institute, Hershey, PA, USA
Search for more papers by this authorTamara Berno
Blood/Marrow and Myeloma Program, University of Utah, Salt Lake City, UT, USA
Search for more papers by this authorMaurizio Zangari
Blood/Marrow and Myeloma Program, University of Utah, Salt Lake City, UT, USA
Search for more papers by this authorAbstract
High-dose melphalan (HD-Mel) is considered the current standard of care among the preparative regimens used in autologous peripheral blood stem cell transplantation (SCT) for multiple myeloma (MM), but optimal time and schedule of administration is not defined. We retrospectively analyzed outcomes and toxicities of HD-Mel administered on day -2 vs. day -1 before autologous stem cells infusion. A total of 138 consecutive MM patients treated at Penn State Hershey Cancer Institute between 2007 and 2010 were included in this study. No difference in time to hematopoietic recovery, common SCT-related toxicities, and clinical outcomes was seen between patients who received HD-Mel on day -2 (group A, n = 47), and those who received it on day -1 (group B, n = 91). Prompt and full hematopoietic recovery occurred even when stem cells were infused between 8 and 24 h after completion of chemotherapy. In the absence of prospective and randomized data, we conclude that a single I.V. infusion of HD-Mel on day -1 is a safe and effective practice, and the so-called ‘day of rest’ before the transplant appears not to be necessary.
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