Plasma cell leukemia
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4 regimens on this page
4 variants on this page
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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, then 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 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 therapy
Lenalidomide monotherapy
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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