Prospective Study of DCEP Chemotherapy in Patients with Relapsed or Refractory Multiple Myeloma
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 12
Abstract
Abstract: Multiple myeloma (MM) is the 2nd most common haematological malignancy among the elderly. Majority of MM patients develop refractoriness/relapse to conventional agents and in such patients, chemotherapy is one of the treatment options. However, prospective data on DCEP (dexamethasone, cyclophosphamide, etoposide, cisplatin) chemotherapy is limited. This phase II prospective study intends to find out the response rate, toxicity and survival outcomes of DCEP infusional chemotherapy in relapsed or refractory MM patients (RRMM) who failed ≥ 2 conventional lines of treatment (including bortezomib and one of the IMiDs). The study period was from January 2012 to December 2013. Twenty one patients were recruited into the study. The median age was 48 years (range 38-63y). Male:female ratio was 12:9. ISS stage I, II and III were equally distributed. Of the 21 patients, 15 completed 6 cycles of DCEP chemotherapy, 4 discontinued and 2 expired after 1st cycle (cause being pneumonia and dengue haemorrhagic fever). Eight (53.3%) had an overall response (complete, very good partial and partial response). The 2 yr and 5 yr progression free survival (PFS) was 10.5% and 5.3% respectively. The 2 yr and 5 yr overall survival (OS) was 46.4% and 37.2% respectively. At a median follow up of 29.1 months, the median PFS was 9.3 months [95% CI 5.2-13.4m] and the median OS was 21.4 months [95% CI 0-46.0m]. There were 5 grade 3/4 haematological toxicities which was managed with prophylactic growth factors and appropriate supportive care. At 5 yr follow up, 4 patients are alive, of whom 3 are on subsequent novel agents and one continues to be in remission. DCEP chemotherapy has good response rate with manageable toxicity and should be considered as a salvage option in RRMM patients. Molecular studies in RRMM are needed to find patients who may get durable benefit with infusional chemotherapy regimens.
Authors and Affiliations
Lakshmi Haridas K, Geetha Narayanan, Sreejith G Nair
Keywords
Related Articles
- EP ID EP480137
- DOI -
- Views 68
- Downloads 0
Oral Hygiene of Children Talibes of the Prefecture of Banamba in Mali: 205 Observations
Abstract: According to WHO, oral health is an essential and integral component of health in general. Alterations in oral health have important consequences: chewing, slurred speech, sleep and concentration, aesthetics an...
Comparative Evaluation of Clonidine and Dexmedetomidine Used For Epidural Analgesia in Lower Abdominal and Lower Limb Surgery
Epidural anaesthesia with adjuvants is the preferred method for intra and postoperative pain relief in lower abdominal and lower limb surgeries but search for ideal adjuvant without any side effect goes on. This study...
Prevalence of Eye Abnormalities in School Going Children in Amritsar -A Study Conducted By a Tertiary Eye Care Centre in an Urban School
Untreated ocular morbidity in schoolchildren is an important condition which can hamper the best intellectual development and academic performance of children. The study was designed to describe the distribution of ocula...
Stigma and Discrimination against Patients with HIV/AIDS in Health Care Settings in Anand District, Gujarat
Among all forms of HIV/AIDS-related stigma and discrimination manifestations; those happening in the health-care settings are probably the most shocking. With a sample size of 115, the study was conducted over a period o...
Occurrence of Vancomycin Resistant Enterococci in Various Clinical Samples
Abstract: Enterococci are an indigenous flora of the intestinal tract, oral cavity and the genitourinary tract of the human beings and animals, are known to be relatively a virulent in healthy individuals but have become...