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Prospective randomised trial of amifostine cytoprotection in myeloma patients undergoing high-dose melphalan conditioned autologous stem cell transplantation

Citation

Spencer, A and Horvath, N and Gibson, J and Prince, HM and Herrmann, R and Bashford, J and Joske, D and Grigg, A and McKendrick, J and Prosser, I and Lowenthal, RM and Deveridge, S and Taylor, K, Prospective randomised trial of amifostine cytoprotection in myeloma patients undergoing high-dose melphalan conditioned autologous stem cell transplantation, Bone Marrow Transplantation, 35, (10) pp. 971-977. ISSN 0268-3369 (2005) [Refereed Article]

DOI: doi:10.1038/sj.bmt.1704946

Abstract

In this prospective multicentre trial, 90 patients undergoing autologous stem cell transplantation (ASCT) were randomised to receive (n = 43) or not receive (n = 47) amifostine 910mg/m2 prior to melphalan 200mg/m2. Patients were monitored for regimen-related toxicity, engraftment, supportive care, response and survival. Both groups underwent ASCT at a median of 8 months from diagnosis and were matched for disease characteristics, prior therapy and pre-ASCT disease responsiveness. Amifostine infusional side-effects were frequent, occurring in 65% of patients, but of mild severity. Amifostine use was associated with a reduction in the median grade of oral mucositis (1 vs 2, P= 0.01) and the frequency of severe (WHO grades 3 or 4) mucositis (12 vs 33%, P = 0.02), but no reduction in the requirement for parenteral nutrition or analgesic use. Conversion to complete remission post-ASCT occurred in 30 and 14% of the amifostine and control groups, respectively (P = 0.09). With a median follow-up of 35 months, there was no statistically significant difference between the median progression-free or overall survival times for the two groups. We conclude that amifostine can be safely administered prior to high-dose melphalan and significantly reduces the frequency and severity of therapy-induced oral mucositis. © 2005 Nature Publishing Group All rights reserved.

Item Details

Item Type:Refereed Article
Research Division:Medical and Health Sciences
Research Group:Oncology and Carcinogenesis
Research Field:Oncology and Carcinogenesis not elsewhere classified
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Cancer and Related Disorders
Author:Lowenthal, RM (Professor Ray Lowenthal)
ID Code:36156
Year Published:2005
Web of Science® Times Cited:49
Deposited By:Medicine (Discipline)
Deposited On:2005-08-01
Last Modified:2012-03-01
Downloads:0

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