Difference between revisions of "Plasma cell leukemia"
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=First-line therapy= | =First-line therapy= | ||
| − | == | + | ==Rd {{#subobject:dc6eae|Regimen=1}}== |
{| class="wikitable" style="float:right; margin-left: 5px;" | {| class="wikitable" style="float:right; margin-left: 5px;" | ||
|- | |- | ||
|[[#top|back to top]] | |[[#top|back to top]] | ||
|} | |} | ||
| − | Ld: '''<u>L</u>'''enalidomide | + | Rd: '''<u>R</u>'''evlimid (Lenalidomide) & low-dose '''<u>d</u>'''examethasone |
| − | + | <br>RevDex: '''<u>Rev</u>'''limid (Lenalidomide) & '''<u>Dex</u>'''amethasone | |
| + | <br>Ld: '''<u>L</u>'''enalidomide & low-dose '''<u>d</u>'''examethasone | ||
| + | <br>Len-Dex: '''<u>L</u>'''enalidomide & '''<u>D</u>'''examethasone | ||
===Regimen {{#subobject:be34d7|Variant=1}}=== | ===Regimen {{#subobject:be34d7|Variant=1}}=== | ||
{| border="1" style="text-align:center;" !align="left" | {| border="1" style="text-align:center;" !align="left" | ||
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'''28-day cycle for 4 cycles''' | '''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 | + | ''Responding patients eligible for transplant proceeded to SCT per center protocol. Responding patients ineligible for transplant received 4 more cycles of Rd, followed by [[#Lenalidomide_monotherapy|lenalidomide maintenance]].'' |
===References=== | ===References=== | ||
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====Preceding treatment==== | ====Preceding treatment==== | ||
| − | *[[# | + | *[[#Rd|Rd]] x 8 |
====Chemotherapy==== | ====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 | ||
Revision as of 02:34, 19 November 2017
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Is there a regimen missing from this list? Would you like to share a different dosage/schedule or an additional reference for a regimen? Have you noticed an error? Do you have an idea that will help the site grow to better meet your needs and the needs of many others? You are invited to contribute to the site.
4 regimens on this page
4 variants on this page
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First-line therapy
Rd
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Rd: Revlimid (Lenalidomide) & low-dose dexamethasone
RevDex: Revlimid (Lenalidomide) & Dexamethasone
Ld: Lenalidomide & low-dose dexamethasone
Len-Dex: Lenalidomide & 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 Rd, 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
- Pegylated liposomal doxorubicin (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 first-line therapy
Melphalan, then autologous stem cell transplant
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Regimen
| Study | Evidence |
| Royer et al. 2016 | Phase II |
Preceding treatment
Chemotherapy
- Melphalan (Alkeran) 200 mg/m2 IV once
- Patients older than 65 years or with CrCl less than 30 mL/min/1.73m2: 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 after first-line therapy
Lenalidomide monotherapy
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Regimen
| Study | Evidence |
| Musto et al. 2013 | Phase II |
Preceding treatment
- Rd 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