Difference between revisions of "Plasma cell leukemia"

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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 [[How_to_contribute|invited to contribute to the site]].
 
 
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!colspan="2" align="center" style="color:white; font-size:125%; background-color:#de2d26"|'''Section editor'''
 
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'''Two 21-day cycles (2 & 4), alternating with PAD'''
 
'''Two 21-day cycles (2 & 4), alternating with PAD'''
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====Subsequent treatment====
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''Responding patients proceeded to undergo  [[#Melphalan.2C_then_auto_HSCT|high-dose melphalan & autologous hematopoietic stem cell transplant]].''
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*Responding patients: [[#Melphalan.2C_then_auto_HSCT|High-dose melphalan & autologous hematopoietic stem cell transplant]]
  
 
===References===
 
===References===
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'''28-day cycle for 4 cycles'''
 
'''28-day cycle for 4 cycles'''
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====Subsequent treatment====
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''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]].''
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*Responding patients eligible for transplant: HSCT per center protocol
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*Responding patients ineligible for transplant received 4 more cycles of Rd, then [[#Lenalidomide_monotherapy|lenalidomide maintenance]]
  
 
===References===
 
===References===
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*[[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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'''28-day cycles until progression'''
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'''28-day cycles'''
  
 
===References===
 
===References===

Revision as of 19:52, 27 June 2018

Section editor
Headshot Cowan.jpg
 Andrew J. Cowan, MD
Seattle, WA
LinkedIn
4 regimens on this page
4 variants on this page


First-line therapy

PAD/VCD

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PAD/VCD: PS-341 (Bortezomib), Adriamycin liposomal (Doxorubicin liposomal), Dexamethasone alternating with Velcade (Bortezomib), Cyclophosphamide, Dexamethasone

Regimen

Study Evidence
Royer et al. 2016 Phase II

Chemotherapy, PAD portion

Two 21-day cycles (1 & 3), alternating with VCD

Chemotherapy, VCD portion

Two 21-day cycles (2 & 4), alternating with PAD

Subsequent treatment

References

  1. 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

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

28-day cycle for 4 cycles

Subsequent treatment

  • Responding patients eligible for transplant: HSCT per center protocol
  • Responding patients ineligible for transplant received 4 more cycles of Rd, then lenalidomide maintenance

References

  1. 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

Consolidation after first-line therapy

Melphalan, then auto HSCT

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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

  1. 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

Chemotherapy

28-day cycles

References

  1. 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
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