- High-dose cyclophosphamide, bortezomib, doxorubicin, and dexamethasone (mCBAD) may be an effective bridge to autologous stem cell transplantation (ASCT) in patients with relapsed/refractory (R/R) multiple myeloma (MM), limited therapeutic options, and good performance scores.
Why this matters
- Multiple myeloma is characterized by refractoriness in advanced stages.
- Review of outcomes in 140 patients with multiple myeloma and plasma cell leukemia receiving mCBAD.
- 13 patients had newly diagnosed multiple myeloma (NDMM), 11 had plasma cell leukemia (PCL), and 116 had R/R MM.
- Many patients had high-risk characteristics including kidney failure (70%), hypercalcemia (53%), anemia (100%), and bony lesions (80%).
- Funding: MD Anderson Cancer Center support grant.
- Overall response rate:
- NDMM: 100%
- PCL: 100%
- R/R MM: 85%.
- Complete response:
- NDMM: 23.1%
- PCL: 10%
- R/R MM: 7.5%.
- In patients with R/R MM:
- 11.48 (95% CI, 7.52-15.9) months median PFS with subsequent ASCT vs 3.19 (95% CI, 2.4-3.75) months without.
- 23 (95% CI, 17.1-36.1) months median OS with subsequent ASCT vs 9 (95% CI, 5.91-13.3) months without.
- 7.8% treatment-related mortality (1 patient with PCL; 10 with R/R MM).
- Retrospective data.