Otro
Liposomal daunorubicin and dexamethasone as a treatment for multiple myeloma - The DD protocol
Registro en:
Sao Paulo Medical Journal, v. 123, n. 6, p. 266-270, 2005.
1516-3180
10.1590/S1516-31802005000600003
S1516-31802005000600003
2-s2.0-33750046937.pdf
2-s2.0-33750046937
Autor
Dulley, Frederico Luiz
Saboya, Rosaura
de Moraes Hungria, Vãnia Tietsche
Bueno, Nadjanara Dorna
de Mello, Fernando Gomes
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
Resumen
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.