Difference between revisions of "Multiple myeloma - historical"

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(Created page with "The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. As a general rule, this includes the inferior arm(s)...")
 
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===References===
 
===References===
 
# Raje N, Powles R, Kulkarni S, Milan S, Middleton G, Singhal S, Mehta J, Millar B, Viner C, Raymond J, Treleaven J, Cunningham D, Gore M. A comparison of vincristine and doxorubicin infusional chemotherapy with methylprednisolone (VAMP) with the addition of weekly cyclophosphamide (C-VAMP) as induction treatment followed by autografting in previously untreated myeloma. Br J Haematol. 1997 Apr;97(1):153-60. [http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2141.1997.d01-2122.x/abstract link to original article] [http://www.ncbi.nlm.nih.gov/pubmed/9136958 PubMed]
 
# Raje N, Powles R, Kulkarni S, Milan S, Middleton G, Singhal S, Mehta J, Millar B, Viner C, Raymond J, Treleaven J, Cunningham D, Gore M. A comparison of vincristine and doxorubicin infusional chemotherapy with methylprednisolone (VAMP) with the addition of weekly cyclophosphamide (C-VAMP) as induction treatment followed by autografting in previously untreated myeloma. Br J Haematol. 1997 Apr;97(1):153-60. [http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2141.1997.d01-2122.x/abstract link to original article] [http://www.ncbi.nlm.nih.gov/pubmed/9136958 PubMed]
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=Consolidation after upfront therapy=
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==Melphalan + TBI -> autologous stem cell transplant {{#subobject:bffa53|Regimen=1}}==
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{| class="wikitable" style="float:right; margin-left: 5px;"
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|-
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|[[#toc|back to top]]
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|}
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===Regimen {{#subobject:f1d04f|Variant=1}}===
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{| border="1" style="text-align:center;" !align="left"
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|'''Study'''
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|[[Levels_of_Evidence#Evidence|'''Evidence''']]
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|'''Comparator'''
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|[[Levels_of_Evidence#Efficacy|'''Efficacy''']]
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|-
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|[http://www.nejm.org/doi/full/10.1056/NEJM199607113350204 Attal et al. 1996]
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|<span
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style="background:#00cd00;
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padding:3px 6px 3px 6px;
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border-color:black;
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border-width:2px;
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border-style:solid;">Phase III</span>
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|VMCP/BVAP x 18
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|<span
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style="background:#00cd00;
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padding:3px 6px 3px 6px;
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border-color:black;
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border-width:2px;
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border-style:solid;">Seems to have superior OS</span>
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|-
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|[http://www.bloodjournal.org/content/99/3/731.long Moreau et al. 2002 (IFM 9502)]
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|<span
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style="background:#00cd00;
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padding:3px 6px 3px 6px;
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border-color:black;
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border-width:2px;
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border-style:solid;">Phase III</span>
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|[[Multiple_myeloma#Melphalan_-.3E_autologous_stem_cell_transplant|High-dose melphalan & autologous transplant]]
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|<span
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style="background:#ff0000;
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padding:3px 6px 3px 6px;
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border-color:black;
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border-width:2px;
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border-style:solid;">Might have inferior OS</span>
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|-
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|}
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''Treatment in '''Attal et al. 1996''' was preceded by 4 to 6 alternating cycles of VMCP and BVAP. Treatment in '''IFM 9502''' was preceded by [[Multiple_myeloma#VAD|VAD]] x 3.''
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*[[Melphalan (Alkeran)]] 140 mg/m2 IV (day not specified)
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*Total-body irradiation in 2 Gy fractions once per day x 4 = total dose of 8 Gy, without lung shielding
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'''One course; relative date of stem cell re-infusion not specified'''
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''Followed by [[Multiple_myeloma#Interferon_alfa|interferon alfa maintenance]].''
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===References===
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# Attal M, Harousseau JL, Stoppa AM, Sotto JJ, Fuzibet JG, Rossi JF, Casassus P, Maisonneuve H, Facon T, Ifrah N, Payen C, Bataille R. A prospective, randomized trial of autologous bone marrow transplantation and chemotherapy in multiple myeloma. Intergroupe Français du Myélome. N Engl J Med. 1996 Jul 11;335(2):91-7. [http://www.nejm.org/doi/full/10.1056/NEJM199607113350204 link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/8649495 PubMed]
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# Moreau P, Facon T, Attal M, Hulin C, Michallet M, Maloisel F, Sotto JJ, Guilhot F, Marit G, Doyen C, Jaubert J, Fuzibet JG, François S, Benboubker L, Monconduit M, Voillat L, Macro M, Berthou C, Dorvaux V, Pignon B, Rio B, Matthes T, Casassus P, Caillot D, Najman N, Grosbois B, Bataille R, Harousseau JL; Intergroupe Francophone du Myélome. Comparison of 200 mg/m(2) melphalan and 8 Gy total body irradiation plus 140 mg/m(2) melphalan as conditioning regimens for peripheral blood stem cell transplantation in patients with newly diagnosed multiple myeloma: final analysis of the Intergroupe Francophone du Myélome 9502 randomized trial. Blood. 2002 Feb 1;99(3):731-5. [http://www.bloodjournal.org/content/99/3/731.long link to original article] [http://www.ncbi.nlm.nih.gov/pubmed/11806971 PubMed]

Revision as of 17:00, 31 March 2016

The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. As a general rule, this includes the inferior arm(s) of a randomized study, unless said regimens continue to be recommended by trustworthy sources such as the NCCN Guidelines. Please go to the multiple myeloma regimen page to find other regimens.

49 regimens on this page
88 variants on this page


Untreated

C-VAMP

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C-VAMP: Cyclophosphamide, Vincristine, Adriamycin (Doxorubicin), MethylPrednisolone

Regimen

Study Evidence Comparator
Raje et al. 1997 Phase III VAMP

References

  1. Raje N, Powles R, Kulkarni S, Milan S, Middleton G, Singhal S, Mehta J, Millar B, Viner C, Raymond J, Treleaven J, Cunningham D, Gore M. A comparison of vincristine and doxorubicin infusional chemotherapy with methylprednisolone (VAMP) with the addition of weekly cyclophosphamide (C-VAMP) as induction treatment followed by autografting in previously untreated myeloma. Br J Haematol. 1997 Apr;97(1):153-60. link to original article PubMed

VAMP

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VAMP: Vincristine, Adriamycin (Doxorubicin), MethylPrednisolone

Regimen

Study Evidence Comparator
Raje et al. 1997 Phase III C-VAMP

References

  1. Raje N, Powles R, Kulkarni S, Milan S, Middleton G, Singhal S, Mehta J, Millar B, Viner C, Raymond J, Treleaven J, Cunningham D, Gore M. A comparison of vincristine and doxorubicin infusional chemotherapy with methylprednisolone (VAMP) with the addition of weekly cyclophosphamide (C-VAMP) as induction treatment followed by autografting in previously untreated myeloma. Br J Haematol. 1997 Apr;97(1):153-60. link to original article PubMed

Consolidation after upfront therapy

Melphalan + TBI -> autologous stem cell transplant

back to top

Regimen

Study Evidence Comparator Efficacy
Attal et al. 1996 Phase III VMCP/BVAP x 18 Seems to have superior OS
Moreau et al. 2002 (IFM 9502) Phase III High-dose melphalan & autologous transplant Might have inferior OS

Treatment in Attal et al. 1996 was preceded by 4 to 6 alternating cycles of VMCP and BVAP. Treatment in IFM 9502 was preceded by VAD x 3.

  • Melphalan (Alkeran) 140 mg/m2 IV (day not specified)
  • Total-body irradiation in 2 Gy fractions once per day x 4 = total dose of 8 Gy, without lung shielding

One course; relative date of stem cell re-infusion not specified

Followed by interferon alfa maintenance.

References

  1. Attal M, Harousseau JL, Stoppa AM, Sotto JJ, Fuzibet JG, Rossi JF, Casassus P, Maisonneuve H, Facon T, Ifrah N, Payen C, Bataille R. A prospective, randomized trial of autologous bone marrow transplantation and chemotherapy in multiple myeloma. Intergroupe Français du Myélome. N Engl J Med. 1996 Jul 11;335(2):91-7. link to original article contains verified protocol PubMed
  2. Moreau P, Facon T, Attal M, Hulin C, Michallet M, Maloisel F, Sotto JJ, Guilhot F, Marit G, Doyen C, Jaubert J, Fuzibet JG, François S, Benboubker L, Monconduit M, Voillat L, Macro M, Berthou C, Dorvaux V, Pignon B, Rio B, Matthes T, Casassus P, Caillot D, Najman N, Grosbois B, Bataille R, Harousseau JL; Intergroupe Francophone du Myélome. Comparison of 200 mg/m(2) melphalan and 8 Gy total body irradiation plus 140 mg/m(2) melphalan as conditioning regimens for peripheral blood stem cell transplantation in patients with newly diagnosed multiple myeloma: final analysis of the Intergroupe Francophone du Myélome 9502 randomized trial. Blood. 2002 Feb 1;99(3):731-5. link to original article PubMed
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