Liposomal daunorubicin and dexamethasone as a treatment for multiple myeloma - The DD protocol

• Autor(a) principal: Dulley, Frederico Luiz
• Data de Publicação: 2005
• Outros Autores: Saboya, Rosaura, de Moraes Hungria, Vãnia Tietsche, Bueno, Nadjanara Dorna, de Mello, Fernando Gomes [UNESP], Frota, Maria Tereza, Chiattone, Carlos Sergio, Barros, José Carlos, Mori, Nair Sumie, Sturaro, Daniel, de Almeida Macedo, Maria Cristina Martins, da Silva, Roberto Luiz, de Melo, Leila Maria Magalhães Pessoa, Souza, Cármino Antonio
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNESP
• Texto Completo: http://dx.doi.org/10.1590/S1516-31802005000600003; http://hdl.handle.net/11449/68477
• topic: Daunorubicin; Dexamethasone; Drug theraphy; Drug toxicity; Multiple myeloma; bleomycin; cyclophosphamide; daunorubicin; dexamethasone; doxorubicin; liposome; melphalan; paraprotein; prednisone; vincristine; adult; aged; alopecia; anemia; anorexia; asthenia; autologous bone marrow transplantation; Brazil; cancer combination chemotherapy; cancer growth; cancer staging; cardiotoxicity; clinical article; clinical trial; controlled clinical trial; controlled study; dose response; drug efficacy; drug fatality; drug response; drug safety; feasibility study; female; gastrointestinal symptom; hematologic malignancy; human; male; multiple myeloma; nausea; neutropenia; pneumonia; prospective study; protein blood level; thrombocytopenia; urinary tract infection; vomiting; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Drug Administration Schedule; Female; Humans; Liposomes; Male; Middle Aged; Multiple Myeloma; Paraproteins; Prospective Studies; Treatment Outcome

Context and Objective: Lipasomial daunorubicin has been used to treat hematological malignancies, including multiple myelomo (MM). The goal was to evaluate efficacy, side-effects and toxicity of liposomal daunorubicin and dexamethasone (DD Protocol). Design and Setting: Prospective study of Sírio-Libonês, São Camilo, Brasil and Alemão Oswaldo Cruz hospitals. Methods: Twenty consecutive patients with active MM received four cycles of liposomal daunorubicin intravenously for two hours (25-30 mg/m 2/day) on three consecutive days per month, with oral dexamethasone, (10 mg every six hours) on four consecutive days three times a month. Results: The male/female ratio was 1:1 and median age 60. Nine patients were stage IIA, ten IIIA and one IIIB. The median from diagnosis to starting DD was 13 months. All patients received four cycles, except one. Fifteen had already received chemotherapy before DD. Responses of > 50% reduction in serum monoclonal paraprotein were observed in six patients after first cycle (30%), six after second (30%) and four after third (20%), while four (20%) did not obtain this. Initially, 17 patients (85%) had anemia: 12 (70%) achieved correction. Progressive disease was observed in three patients (15%), while one had minimal response, four (20%) partial and 12 (60%) complete. Hemotologlical toxicity was acceptable: three patients (15%) had neutrophils < 1,000/mm 3; none had thrombocyfopenia. Gastrointestinal toxicity was mild: nausea (10%), anorexio (15%) and no vomiting. Conclusions: This treatment has mild toxicity and good response rate. It may therefore be feasible before autologous bone marraw transplantation.