Multiple Myeloma Clinical Trial
Auto Transplant High Dose Melphalan vs High Dose Melphalan+Bortezomib in Pts With Multiple Myeloma Age 65 Years or Older
Summary
In this study the investigators are comparing this standard regimen to the newly established regimen of melphalan and bortezomib.
Full Description
In this study the investigators are comparing this standard regimen to the newly established regimen of melphalan and bortezomib.
Conditioning Regimens:
Treatment arm A Melphalan is administered at a dose of 200mg/m2 by rapid intravenous infusion via a central or peripheral vein over 30 minutes to one hour.
Melphalan will be given as a single dose (not split over 2 or more days) and given on day-1.
Dosing will be based on body surface area calculated using actual body weight
Stem cell infusion:
Stem cell infusion will occur on day 0 and will be at least 20 hours after the infusion of melphalan. The infusion of peripheral blood stem cells will be done in accordance with the Blood and Marrow Transplant program standard operating procedures.
Filgrastim will be administered at a dose of 5 mcg/kg (rounded to vial size) every other day starting on day+3 then daily starting on day 9 until engraftment (at least).
Treatment arm B
Bortezomib:
Bortezomib is administered by rapid I.V. push (over 3-5 seconds) via a central or peripheral vein into a flowing saline line. Bortezomib will be administered any time on day -4 and at least 20 hrs after the start of the melphalan infusion on day -1.
Dosing will be based on actual body weight. Dexamethasone is administered at a dose of 20 mg IV prior to each bortezomib infusion.
Melphalan:
Melphalan is administered at a dose of 200mg/m2 by rapid intravenous infusion via a central or peripheral vein over 30 minutes to one hour.
Melphalan will be given as a single dose (not split over 2 or more days) and given of day-2.
Dosing will be based body surface area calculated using actual body weight
Stem cell infusion:
Stem cell infusion will occur on day 0 and will be at least 18 hours after the infusion of the bortezomib. The infusion of peripheral blood stem cells will be done in accordance with the Blood and Marrow Transplant program standard operating procedures.
Filgrastim will be administered at a dose of 5 mcg/kg (rounded to vial size) every other day starting on day+3 then daily starting on day 9 until engraftment (at least).
Post-transplant Supportive Care will be administered in accordance to the Blood and Marrow Transplant program standard operating procedures.
Eligibility Criteria
Inclusion Criteria:
Confirmed diagnosis of multiple myeloma less than 12 months since initiation of systemic therapy
Age ≥60 years at time of transplantation
KPS 70-100%
Recovery from complications of prior therapy
Exclusion Criteria:
Diagnosis other than multiple myeloma
Chemotherapy or radiotherapy within 8 days of initiating treatment in this study
Prior dose-intense therapy within 56 days of initiating treatment in this study
Uncontrolled bacterial, viral, fungal or parasitic infections
Uncontrolled CNS metastases
Known amyloid deposition in heart
Organ dysfunction
LVEF <40% or cardiac failure not responsive to therapy
FVC, FEV1 or DLCO < 40% of predicted and/or receiving supplementary continuous oxygen
Evidence of hepatic synthetic dysfunction or total bilirubin > 2x or AST > 3x ULN
Measured creatinine < 20ml/min
Sensory peripheral neuropathy grade 4 within 14 days of enrollment
Karnofsky score < 70%
Life expectancy limited by other co-morbid illnesses
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There are 2 Locations for this study
Washington District of Columbia, 20057, United States
Hackensack New Jersey, 07601, United States
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