Amifostine reduces gastro-intestinal toxicity after autologous transplantation for multiple myeloma.

Abstract:

:High-dose melphalan (HDM) followed by autologous hematopoietic cell transplantation (auto-HCT) remains the standard-of-care therapy for multiple myeloma (MM) even with the availability of proteasome inhibitors and immunomodulatory drugs. Gastrointestinal (GI) toxicity is the main cause of morbidity after HDM. Amifostine, a cytoprotective agent, may reduce HDM-associated GI toxicity. We conducted a case control study comparing HDM + auto-HCT with or without amifostine for MM patients. One hundred and seven patients treated at University Hospitals Cleveland Medical Center who received pre-transplant amifostine were compared to 114 patients treated at MD Anderson Cancer Center without use of this agent. Amifostine 740 mg/m2 was administered as a bolus infusion at 24 h and 15 min before HDM. Patients' characteristics were similar in both the groups. Amifostine therapy was well tolerated without any significant adverse effects. Grade II or greater oral mucositis (27.1% vs 47.4%; p = .002), nausea (31.8% vs. 86.0%; p = .0001), vomiting (18.7% vs. 52.6%; p = .0001) and diarrhea (56.1% vs. 72.7%; p = .006) occurred less frequently in the amifostine-treated group. There was no discernable effect of amifostine on engraftment, progression-free or overall survival. Our results indicate that amifostine decreases GI toxicity while preserving anti-myeloma efficacy of HDM and auto-HCT.

journal_name

Leuk Lymphoma

journal_title

Leukemia & lymphoma

authors

Malek E,Gupta V,Creger R,Caimi P,Vatsayan A,Covut F,Bashir Q,Champlin R,Delgado R,Rondon G,Cooper B,de Lima M,Lazarus HM,Qazilbash M

doi

10.1080/10428194.2017.1408086

subject

Has Abstract

pub_date

2018-08-01 00:00:00

pages

1905-1912

issue

8

eissn

1042-8194

issn

1029-2403

journal_volume

59

pub_type

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