Difference between revisions of "Plasma cell leukemia"
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=Guidelines= | =Guidelines= | ||
==EMN== | ==EMN== | ||
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==IMWG== | ==IMWG== | ||
*'''2012:''' de Larrea et al. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4112539/ Consensus Statement on Diagnostic Requirements, Response Criteria, and Treatment Recommendations by the International Myeloma Working Group (IMWG)] | *'''2012:''' de Larrea et al. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4112539/ Consensus Statement on Diagnostic Requirements, Response Criteria, and Treatment Recommendations by the International Myeloma Working Group (IMWG)] | ||
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=First-line therapy= | =First-line therapy= | ||
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==PAD/VCD {{#subobject:cc293b|Regimen=1}}== | ==PAD/VCD {{#subobject:cc293b|Regimen=1}}== | ||
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PAD/VCD: '''<u>P</u>'''S-341 (Bortezomib), '''<u>A</u>'''driamycin liposomal (Pegylated liposomal doxorubicin), '''<u>D</u>'''examethasone alternating with '''<u>V</u>'''elcade (Bortezomib), '''<u>C</u>'''yclophosphamide, '''<u>D</u>'''examethasone | PAD/VCD: '''<u>P</u>'''S-341 (Bortezomib), '''<u>A</u>'''driamycin liposomal (Pegylated liposomal doxorubicin), '''<u>D</u>'''examethasone alternating with '''<u>V</u>'''elcade (Bortezomib), '''<u>C</u>'''yclophosphamide, '''<u>D</u>'''examethasone | ||
| − | + | <div class="toccolours" style="background-color:#eeeeee"> | |
===Regimen {{#subobject:9763fb|Variant=1}}=== | ===Regimen {{#subobject:9763fb|Variant=1}}=== | ||
{| class="wikitable" style="width: 40%; text-align:center;" | {| class="wikitable" style="width: 40%; text-align:center;" | ||
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|} | |} | ||
| + | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Targeted therapy==== | ====Targeted therapy==== | ||
*[[Bortezomib (Velcade)]] 1.3 mg/m<sup>2</sup> SC once per day on days 1, 4, 8, 11 | *[[Bortezomib (Velcade)]] 1.3 mg/m<sup>2</sup> SC once per day on days 1, 4, 8, 11 | ||
| − | |||
====Chemotherapy, PAD portion==== | ====Chemotherapy, PAD portion==== | ||
*[[Pegylated liposomal doxorubicin (Doxil)]] as follows: | *[[Pegylated liposomal doxorubicin (Doxil)]] as follows: | ||
**Cycles 1 & 3: 30 mg/m<sup>2</sup> IV once on day 4 | **Cycles 1 & 3: 30 mg/m<sup>2</sup> IV once on day 4 | ||
| − | |||
====Chemotherapy, VCD portion==== | ====Chemotherapy, VCD portion==== | ||
*[[Cyclophosphamide (Cytoxan)]] as follows: | *[[Cyclophosphamide (Cytoxan)]] as follows: | ||
**Cycles 2 & 4: 300 mg/m<sup>2</sup> PO once per day on days 1 & 8 | **Cycles 2 & 4: 300 mg/m<sup>2</sup> PO once per day on days 1 & 8 | ||
| − | |||
====Glucocorticoid therapy==== | ====Glucocorticoid therapy==== | ||
*[[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 | ||
| − | |||
'''21-day cycle for 4 cycles''' | '''21-day cycle for 4 cycles''' | ||
| + | </div> | ||
| + | <div class="toccolours" style="background-color:#cbd5e7"> | ||
====Subsequent treatment==== | ====Subsequent treatment==== | ||
*Responding patients: [[#Melphalan.2C_then_auto_HSCT|High-dose melphalan & autologous hematopoietic stem cell transplant]] | *Responding patients: [[#Melphalan.2C_then_auto_HSCT|High-dose melphalan & autologous hematopoietic stem cell transplant]] | ||
| − | + | </div></div> | |
===References=== | ===References=== | ||
<!-- Presented at the 55th American Society of Hematology Annual Meeting, New Orleans, LA, December 7-10, 2013, and the 40th Annual Meeting of the European Society for Blood and Marrow Transplantation, Milan, Italy, March 30 to April 2, 2014. --> | <!-- Presented at the 55th American Society of Hematology Annual Meeting, New Orleans, LA, December 7-10, 2013, and the 40th Annual Meeting of the European Society for Blood and Marrow Transplantation, Milan, Italy, March 30 to April 2, 2014. --> | ||
# 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; IFM. 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. [https://doi.org/10.1200/jco.2015.63.1929 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/27114594 PubMed] EudraCT 2009-016607-33 | # 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; IFM. 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. [https://doi.org/10.1200/jco.2015.63.1929 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/27114594 PubMed] EudraCT 2009-016607-33 | ||
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==Lenalidomide & Dexamethasone (Rd) {{#subobject:dc6eae|Regimen=1}}== | ==Lenalidomide & Dexamethasone (Rd) {{#subobject:dc6eae|Regimen=1}}== | ||
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Rd: '''<u>R</u>'''evlimid (Lenalidomide) & low-dose '''<u>d</u>'''examethasone | Rd: '''<u>R</u>'''evlimid (Lenalidomide) & low-dose '''<u>d</u>'''examethasone | ||
<br>RevDex: '''<u>Rev</u>'''limid (Lenalidomide) & '''<u>Dex</u>'''amethasone | <br>RevDex: '''<u>Rev</u>'''limid (Lenalidomide) & '''<u>Dex</u>'''amethasone | ||
<br>Ld: '''<u>L</u>'''enalidomide & low-dose '''<u>d</u>'''examethasone | <br>Ld: '''<u>L</u>'''enalidomide & low-dose '''<u>d</u>'''examethasone | ||
<br>LenDex: '''<u>L</u>'''enalidomide & '''<u>D</u>'''examethasone | <br>LenDex: '''<u>L</u>'''enalidomide & '''<u>D</u>'''examethasone | ||
| + | <div class="toccolours" style="background-color:#eeeeee"> | ||
===Regimen {{#subobject:be34d7|Variant=1}}=== | ===Regimen {{#subobject:be34d7|Variant=1}}=== | ||
{| class="wikitable" style="width: 40%; text-align:center;" | {| class="wikitable" style="width: 40%; text-align:center;" | ||
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|- | |- | ||
|} | |} | ||
| + | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Targeted therapy==== | ====Targeted therapy==== | ||
*[[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 | ||
====Glucocorticoid therapy==== | ====Glucocorticoid therapy==== | ||
*[[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 for 4 cycles''' | '''28-day cycle for 4 cycles''' | ||
| + | </div> | ||
| + | <div class="toccolours" style="background-color:#cbd5e7"> | ||
====Subsequent treatment==== | ====Subsequent treatment==== | ||
*Responding patients eligible for transplant: HSCT per center protocol | *Responding patients eligible for transplant: HSCT per center protocol | ||
*Responding patients ineligible for transplant received 4 more cycles of Rd, then [[#Lenalidomide_monotherapy|lenalidomide]] maintenance | *Responding patients ineligible for transplant received 4 more cycles of Rd, then [[#Lenalidomide_monotherapy|lenalidomide]] maintenance | ||
| − | + | </div></div> | |
===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. [https://doi.org/10.1038/leu.2013.241 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/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. [https://doi.org/10.1038/leu.2013.241 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/23958922 PubMed] | ||
| − | |||
=Consolidation after first-line therapy= | =Consolidation after first-line therapy= | ||
| − | |||
==Melphalan, then auto HSCT {{#subobject:5cf2b0|Regimen=1}}== | ==Melphalan, then auto HSCT {{#subobject:5cf2b0|Regimen=1}}== | ||
| − | + | <div class="toccolours" style="background-color:#eeeeee"> | |
| − | |||
===Regimen {{#subobject:e8054d|Variant=1}}=== | ===Regimen {{#subobject:e8054d|Variant=1}}=== | ||
{| class="wikitable" style="width: 40%; text-align:center;" | {| class="wikitable" style="width: 40%; text-align:center;" | ||
| Line 102: | Line 95: | ||
|- | |- | ||
|} | |} | ||
| + | <div class="toccolours" style="background-color:#cbd5e8"> | ||
====Preceding treatment==== | ====Preceding treatment==== | ||
*[[#PAD.2FVCD|PAD alternating with VCD]] | *[[#PAD.2FVCD|PAD alternating with VCD]] | ||
| + | </div> | ||
| + | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Chemotherapy==== | ====Chemotherapy==== | ||
*[[Melphalan (Alkeran)]] IV once (day not specified) by the following criteria: | *[[Melphalan (Alkeran)]] IV once (day not specified) by the following criteria: | ||
**65 or younger with CrCl of 30 mL/min/1.73m<sup>2</sup> or greater: 200 mg/m<sup>2</sup> | **65 or younger with CrCl of 30 mL/min/1.73m<sup>2</sup> or greater: 200 mg/m<sup>2</sup> | ||
**Patients older than 65 years or with CrCl less than 30 mL/min/1.73m<sup>2</sup>: 140 mg/m<sup>2</sup> | **Patients older than 65 years or with CrCl less than 30 mL/min/1.73m<sup>2</sup>: 140 mg/m<sup>2</sup> | ||
| − | + | </div></div> | |
===References=== | ===References=== | ||
<!-- Presented at the 55th American Society of Hematology Annual Meeting, New Orleans, LA, December 7-10, 2013, and the 40th Annual Meeting of the European Society for Blood and Marrow Transplantation, Milan, Italy, March 30 to April 2, 2014. --> | <!-- Presented at the 55th American Society of Hematology Annual Meeting, New Orleans, LA, December 7-10, 2013, and the 40th Annual Meeting of the European Society for Blood and Marrow Transplantation, Milan, Italy, March 30 to April 2, 2014. --> | ||
# 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. [https://doi.org/10.1200/jco.2015.63.1929 link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/27114594 PubMed] EudraCT 2009-016607-33 | # 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. [https://doi.org/10.1200/jco.2015.63.1929 link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/27114594 PubMed] EudraCT 2009-016607-33 | ||
| − | |||
=Maintenance after first-line therapy= | =Maintenance after first-line therapy= | ||
| − | |||
==Lenalidomide monotherapy {{#subobject:bec321|Regimen=1}}== | ==Lenalidomide monotherapy {{#subobject:bec321|Regimen=1}}== | ||
| − | + | <div class="toccolours" style="background-color:#eeeeee"> | |
| − | |||
===Regimen {{#subobject:45c352|Variant=1}}=== | ===Regimen {{#subobject:45c352|Variant=1}}=== | ||
{| class="wikitable" style="width: 40%; text-align:center;" | {| class="wikitable" style="width: 40%; text-align:center;" | ||
| Line 127: | Line 120: | ||
|- | |- | ||
|} | |} | ||
| + | <div class="toccolours" style="background-color:#cbd5e8"> | ||
====Preceding treatment==== | ====Preceding treatment==== | ||
*[[#Lenalidomide_.26_Dexamethasone_.28Rd.29|Rd]] x 8 | *[[#Lenalidomide_.26_Dexamethasone_.28Rd.29|Rd]] x 8 | ||
| + | </div> | ||
| + | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Targeted therapy==== | ====Targeted therapy==== | ||
*[[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 | ||
| − | |||
'''28-day cycles''' | '''28-day cycles''' | ||
| − | + | </div></div> | |
===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. [https://doi.org/10.1038/leu.2013.241 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/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. [https://doi.org/10.1038/leu.2013.241 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/23958922 PubMed] | ||
| − | |||
[[Category:Plasma cell leukemia regimens]] | [[Category:Plasma cell leukemia regimens]] | ||
[[Category:Disease-specific pages]] | [[Category:Disease-specific pages]] | ||
[[Category:Plasma cell dyscrasias]] | [[Category:Plasma cell dyscrasias]] | ||
Revision as of 17:29, 28 February 2023
| Section editor | |
|---|---|
 |
Andrew J. Cowan, MD University of Washington Seattle, WA  andrewcowanmd |
4 regimens on this page
4 variants on this page
|
Guidelines
EMN
- 2018: Gavriatopoulou et al. European myeloma network recommendations on diagnosis and management of patients with rare plasma cell dyscrasias PubMed
IMWG
- 2012: de Larrea et al. Consensus Statement on Diagnostic Requirements, Response Criteria, and Treatment Recommendations by the International Myeloma Working Group (IMWG)
First-line therapy
PAD/VCD
PAD/VCD: PS-341 (Bortezomib), Adriamycin liposomal (Pegylated liposomal doxorubicin), Dexamethasone alternating with Velcade (Bortezomib), Cyclophosphamide, Dexamethasone
Regimen
| Study | Evidence |
|---|---|
| Royer et al. 2016 | Phase 2 |
Targeted therapy
- Bortezomib (Velcade) 1.3 mg/m2 SC once per day on days 1, 4, 8, 11
Chemotherapy, PAD portion
- Pegylated liposomal doxorubicin (Doxil) as follows:
- Cycles 1 & 3: 30 mg/m2 IV once on day 4
Chemotherapy, VCD portion
- Cyclophosphamide (Cytoxan) as follows:
- Cycles 2 & 4: 300 mg/m2 PO once per day on days 1 & 8
Glucocorticoid therapy
- Dexamethasone (Decadron) 40 mg PO once per day on days 1, 4, 8, 11
21-day cycle for 4 cycles
Subsequent treatment
- Responding patients: High-dose melphalan & autologous hematopoietic 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; IFM. 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 dosing details in manuscript PubMed EudraCT 2009-016607-33
Lenalidomide & Dexamethasone (Rd)
Rd: Revlimid (Lenalidomide) & low-dose dexamethasone
RevDex: Revlimid (Lenalidomide) & Dexamethasone
Ld: Lenalidomide & low-dose dexamethasone
LenDex: Lenalidomide & Dexamethasone
Regimen
| Study | Evidence |
|---|---|
| Musto et al. 2013 | Phase 2 |
Targeted therapy
- Lenalidomide (Revlimid) 25 mg PO once per day on days 1 to 21
Glucocorticoid therapy
- Dexamethasone (Decadron) 40 mg PO once per day on days 1, 8, 15, 22
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
- 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 dosing details in manuscript PubMed
Consolidation after first-line therapy
Melphalan, then auto HSCT
Regimen
| Study | Evidence |
|---|---|
| Royer et al. 2016 | Phase 2 |
Preceding treatment
Chemotherapy
- Melphalan (Alkeran) IV once (day not specified) by the following criteria:
- 65 or younger with CrCl of 30 mL/min/1.73m2 or greater: 200 mg/m2
- 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 dosing details in abstract PubMed EudraCT 2009-016607-33
Maintenance after first-line therapy
Lenalidomide monotherapy
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 dosing details in manuscript PubMed