Difference between revisions of "Plasma cell leukemia"
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− | + | ====Chemotherapy==== | |
*[[Lenalidomide (Revlimid)]] 25 mg PO once per day on days 1 to 21 | *[[Lenalidomide (Revlimid)]] 25 mg PO once per day on days 1 to 21 | ||
*[[Dexamethasone (Decadron)]] 40 mg PO once per day on days 1, 8, 15, 22 | *[[Dexamethasone (Decadron)]] 40 mg PO once per day on days 1, 8, 15, 22 | ||
− | '''28-day cycle | + | '''28-day cycle for 4 cycles''' |
''Responding patients eligible for transplant proceeded to SCT per center protocol. Responding patients ineligible for transplant received 4 more cycles of Ld, followed by [[#Lenalidomide_.28Revlimid.29|lenalidomide maintenance]].'' | ''Responding patients eligible for transplant proceeded to SCT per center protocol. Responding patients ineligible for transplant received 4 more cycles of Ld, followed by [[#Lenalidomide_.28Revlimid.29|lenalidomide maintenance]].'' | ||
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====PAD portion==== | ====PAD portion==== | ||
− | *[[Bortezomib (Velcade)]] 1.3 mg/ | + | *[[Bortezomib (Velcade)]] 1.3 mg/m<sup>2</sup> SC once per day on days 1, 4, 8, 11 |
− | *[[Doxorubicin liposomal (Doxil)]] 30 mg/ | + | *[[Doxorubicin liposomal (Doxil)]] 30 mg/m<sup>2</sup> IV once on day 4 |
*[[Dexamethasone (Decadron)]] 40 mg PO once per day on days 1, 4, 8, 11 | *[[Dexamethasone (Decadron)]] 40 mg PO once per day on days 1, 4, 8, 11 | ||
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====VCD portion==== | ====VCD portion==== | ||
− | *[[Bortezomib (Velcade)]] 1.3 mg/ | + | *[[Bortezomib (Velcade)]] 1.3 mg/m<sup>2</sup> SC once per day on days 1, 4, 8, 11 |
− | *[[Cyclophosphamide (Cytoxan)]] 300 mg/ | + | *[[Cyclophosphamide (Cytoxan)]] 300 mg/m<sup>2</sup> PO once per day on days 1 & 8 |
*[[Dexamethasone (Decadron)]] 40 mg PO once per day on days 1, 4, 8, 11 | *[[Dexamethasone (Decadron)]] 40 mg PO once per day on days 1, 4, 8, 11 | ||
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''Treatment preceded by [[#PAD.2FVCD|PAD alternating with VCD]].'' | ''Treatment preceded by [[#PAD.2FVCD|PAD alternating with VCD]].'' | ||
====Chemotherapy==== | ====Chemotherapy==== | ||
− | *[[Melphalan (Alkeran)]] 200 mg/ | + | *[[Melphalan (Alkeran)]] 200 mg/m<sup>2</sup> IV once |
**Patients > 65 years or with CrCl < 30 mL/min received 140 mg/m2 | **Patients > 65 years or with CrCl < 30 mL/min received 140 mg/m2 | ||
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''Treatment preceded by [[#Ld|Ld]] x 8.'' | ''Treatment preceded by [[#Ld|Ld]] x 8.'' | ||
− | + | ====Chemotherapy==== | |
*[[Lenalidomide (Revlimid)]] 10 mg PO once per day on days 1 to 21 | *[[Lenalidomide (Revlimid)]] 10 mg PO once per day on days 1 to 21 | ||
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===References=== | ===References=== | ||
# Musto P, Simeon V, Martorelli MC, Petrucci MT, Cascavilla N, Di Raimondo F, Caravita T, Morabito F, Offidani M, Olivieri A, Benevolo G, Mina R, Guariglia R, D'Arena G, Mansueto G, Filardi N, Nobile F, Levi A, Falcone A, Cavalli M, Pietrantuono G, Villani O, Bringhen S, Omedè P, Lerose R, Agnelli L, Todoerti K, Neri A, Boccadoro M, Palumbo A. Lenalidomide and low-dose dexamethasone for newly diagnosed primary plasma cell leukemia. Leukemia. 2014 Jan;28(1):222-5. Epub 2013 Aug 20. [http://www.nature.com/leu/journal/v28/n1/full/leu2013241a.html link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/23958922 PubMed] | # Musto P, Simeon V, Martorelli MC, Petrucci MT, Cascavilla N, Di Raimondo F, Caravita T, Morabito F, Offidani M, Olivieri A, Benevolo G, Mina R, Guariglia R, D'Arena G, Mansueto G, Filardi N, Nobile F, Levi A, Falcone A, Cavalli M, Pietrantuono G, Villani O, Bringhen S, Omedè P, Lerose R, Agnelli L, Todoerti K, Neri A, Boccadoro M, Palumbo A. Lenalidomide and low-dose dexamethasone for newly diagnosed primary plasma cell leukemia. Leukemia. 2014 Jan;28(1):222-5. Epub 2013 Aug 20. [http://www.nature.com/leu/journal/v28/n1/full/leu2013241a.html link to original article] '''contains verified protocol''' [http://www.ncbi.nlm.nih.gov/pubmed/23958922 PubMed] | ||
+ | |||
+ | [[Category:Chemotherapy regimens]] | ||
+ | [[Category:Malignant hematology regimens]] | ||
+ | [[Category:Leukemia regimens]] | ||
+ | [[Category:Plasma cell neoplasm regimens]] |
Revision as of 17:50, 30 June 2016
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4 regimens on this page
4 variants on this page
|
Untreated
Ld
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Ld: Lenalidomide, low dose dexamethasone
Regimen
Study | Evidence |
Musto et al. 2013 | Phase II |
Chemotherapy
- Lenalidomide (Revlimid) 25 mg PO once per day on days 1 to 21
- Dexamethasone (Decadron) 40 mg PO once per day on days 1, 8, 15, 22
28-day cycle for 4 cycles
Responding patients eligible for transplant proceeded to SCT per center protocol. Responding patients ineligible for transplant received 4 more cycles of Ld, followed by lenalidomide maintenance.
References
- Musto P, Simeon V, Martorelli MC, Petrucci MT, Cascavilla N, Di Raimondo F, Caravita T, Morabito F, Offidani M, Olivieri A, Benevolo G, Mina R, Guariglia R, D'Arena G, Mansueto G, Filardi N, Nobile F, Levi A, Falcone A, Cavalli M, Pietrantuono G, Villani O, Bringhen S, Omedè P, Lerose R, Agnelli L, Todoerti K, Neri A, Boccadoro M, Palumbo A. Lenalidomide and low-dose dexamethasone for newly diagnosed primary plasma cell leukemia. Leukemia. 2014 Jan;28(1):222-5. Epub 2013 Aug 20. link to original article contains verified protocol PubMed
PAD/VCD
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PAD: PS-341 (Bortezomib), Adriamycin liposomal (Doxorubicin liposomal), Dexamethasone
VCD: Velcade (Bortezomib), Cyclophosphamide, Dexamethasone
Regimen
Study | Evidence |
Royer et al. 2016 | Phase II |
PAD portion
- Bortezomib (Velcade) 1.3 mg/m2 SC once per day on days 1, 4, 8, 11
- Doxorubicin liposomal (Doxil) 30 mg/m2 IV once on day 4
- Dexamethasone (Decadron) 40 mg PO once per day on days 1, 4, 8, 11
Two 21-day cycles (1 & 3), alternating with VCD
VCD portion
- Bortezomib (Velcade) 1.3 mg/m2 SC once per day on days 1, 4, 8, 11
- Cyclophosphamide (Cytoxan) 300 mg/m2 PO once per day on days 1 & 8
- Dexamethasone (Decadron) 40 mg PO once per day on days 1, 4, 8, 11
Two 21-day cycles (2 & 4), alternating with PAD
Responding patients proceeded to undergo high-dose melphalan & autologous stem cell transplant.
References
- Royer B, Minvielle S, Diouf M, Roussel M, Karlin L, Hulin C, Arnulf B, Macro M, Cailleres S, Brion A, Brechignac S, Belhadj K, Chretien ML, Wetterwald M, Chaleteix C, Tiab M, Leleu X, Frenzel L, Garderet L, Choquet S, Fuzibet JG, Dauriac C, Forneker LM, Benboubker L, Facon T, Moreau P, Avet-Loiseau H, Marolleau JP. Bortezomib, Doxorubicin, Cyclophosphamide, Dexamethasone Induction Followed by Stem Cell Transplantation for Primary Plasma Cell Leukemia: A Prospective Phase II Study of the Intergroupe Francophone du Myélome. J Clin Oncol. 2016 Jun 20;34(18):2125-32. Epub 2016 Apr 25. link to original article contains verified protocol PubMed
Consolidation after upfront therapy
Melphalan -> autologous stem cell transplant
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Regimen
Study | Evidence |
Royer et al. 2016 | Phase II |
Treatment preceded by PAD alternating with VCD.
Chemotherapy
- Melphalan (Alkeran) 200 mg/m2 IV once
- Patients > 65 years or with CrCl < 30 mL/min received 140 mg/m2
References
- Royer B, Minvielle S, Diouf M, Roussel M, Karlin L, Hulin C, Arnulf B, Macro M, Cailleres S, Brion A, Brechignac S, Belhadj K, Chretien ML, Wetterwald M, Chaleteix C, Tiab M, Leleu X, Frenzel L, Garderet L, Choquet S, Fuzibet JG, Dauriac C, Forneker LM, Benboubker L, Facon T, Moreau P, Avet-Loiseau H, Marolleau JP. Bortezomib, Doxorubicin, Cyclophosphamide, Dexamethasone Induction Followed by Stem Cell Transplantation for Primary Plasma Cell Leukemia: A Prospective Phase II Study of the Intergroupe Francophone du Myélome. J Clin Oncol. 2016 Jun 20;34(18):2125-32. Epub 2016 Apr 25. link to original article contains protocol PubMed
Maintenance therapy
Lenalidomide (Revlimid)
back to top |
Regimen
Study | Evidence |
Musto et al. 2013 | Phase II |
Treatment preceded by Ld x 8.
Chemotherapy
- Lenalidomide (Revlimid) 10 mg PO once per day on days 1 to 21
28-day cycles until progression
References
- Musto P, Simeon V, Martorelli MC, Petrucci MT, Cascavilla N, Di Raimondo F, Caravita T, Morabito F, Offidani M, Olivieri A, Benevolo G, Mina R, Guariglia R, D'Arena G, Mansueto G, Filardi N, Nobile F, Levi A, Falcone A, Cavalli M, Pietrantuono G, Villani O, Bringhen S, Omedè P, Lerose R, Agnelli L, Todoerti K, Neri A, Boccadoro M, Palumbo A. Lenalidomide and low-dose dexamethasone for newly diagnosed primary plasma cell leukemia. Leukemia. 2014 Jan;28(1):222-5. Epub 2013 Aug 20. link to original article contains verified protocol PubMed