Ma. Kazmi et al., The effects of prior induction therapy with melphalan on subsequent peripheral blood progenitor cell transplantation for myeloma, CLIN LAB H, 23(2), 2001, pp. 125-129
High dose chemoradiotherapy with autologous peripheral blood progenitor cel
l transplantation (PBPCT) may improve outcome in myeloma. Melphalan is an e
ffective drug in the treatment of myeloma, but is potentially toxic to prog
enitor cells. We studied 8 patients receiving intermittent intravenous melp
halan (25 mg/m(2)) as induction therapy before PBPCT to assess engraftment
characteristics post-transplantation. Comparison was made with an age-match
ed control group of patients with non-Hodgkins lymphoma who had not receive
d melphalan during induction therapy. There was correlation (P=0.037) betwe
en the dose of melphalan per kg body weight given, premobilization, and day
s to neutrophil engraftment, but no significant difference between the two
groups in neutrophil recovery. The study group had delayed platelet recover
y (P=0.01) and required more platelet support post-transplantation (P=0.05)
. 3-4 weekly melphalan (25 mg/m(2)) up to 6 courses was delivered to patien
ts who went on to PBPCT without significantly influencing neutrophil recove
ry but with a negative impact on platelet recovery.