Phase 2
N=10
Melphalan, Bortezomib, and Stem Cell Transplant in Treating Patients With Primary Systemic Amyloidosis
Multiple Myeloma
Bottom Line
View on ClinicalTrials.gov: NCT00790647 ↗Enrolled (actual)
10
Serious AEs
100.0%
Results posted
Feb 2017
Primary outcome: Primary: Number of Participants With Hematologic Response — 6 participants
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- filgrastim (Biological); bortezomib (Drug); melphalan (Drug); Stem Cell Infusion (Procedure)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Boston Medical Center
- Primary completion
- Dec 2012
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Number of Participants With Hematologic Response |
6 | — |
| SECONDARY Number of Participants Surviving at 100 Days From Transplant |
9 | — |
| SECONDARY Number of Participants Surviving at 1 Year |
9 | — |
| SECONDARY Number of Participants Surviving at 2 Years |
9 | — |
Summary
RATIONALE: Giving melphalan and bortezomib before and after a stem cell transplant stops the growth of abnormal cells by stopping them from dividing or killing them. Giving colony-stimulating factors and certain chemotherapy drugs, helps stem cells move from the bone marrow to the blood so they can be collected and stored. Chemotherapy and monoclonal antibody therapy is then given to prepare the bone marrow for the stem cell transplant. The stem cells are then returned to the patient to replace the blood-forming cells that were destroyed by the chemotherapy.
PURPOSE: This phase II trial is studying how well giving melphalan together with bortezomib followed by stem cell transplant works in treating patients with primary systemic amyloidosis.
Eligibility Criteria
Inclusion criteria
DISEASE CHARACTERISTICS:
- Histologically confirmed primary systemic amyloidosis based on the following criteria:
- Amyloid light-chain disease
- Deposition of amyloid material by congo red stain showing characteristic green birefringence
- Monoclonal light chain protein (Bence Jones protein) in the serum or urine, immunohistochemical studies, or serum free light chain assay
- Evidence of tissue involvement other than carpal tunnel syndrome (i.e., positive immunohistochemical staining of bone marrow demonstrating clonal plasma cells); tissue amyloid deposits with anti-kappa or anti-lambda anti-serum; evidence for a plasma cell dyscrasia by serum/urine or bone marrow; or overwhelmingly convincing clinical features (e.g., macroglossia) associated with other systemic manifestations
PATIENT CHARACTERISTICS:
- Southwest Oncology Group performance status 0-1
- Fertile patients must use effective contraception
- Left ventricular ejection fraction ≥ 45% by Echocardiogram within the past 60 days
- diffusion capacity of lung for carbon monoxide ≥ 50%
PRIOR CONCURRENT THERAPY:
- Prior chemotherapy with alkylating agent allowed provided there is no morphological or cytogenetic evidence of myelodysplastic syndromes
- Prior total cumulative dose of oral melphalan 30% of bone marrow plasmacytosis, extensive [> 2] lytic lesions, or hypercalcemia)
- Not pregnant or nursing
- No myocardial infarction within the past 6 months, congestive heart failure, or arrhythmia refractory to therapy
- No prior malignancy except for any of the following:
- Adequately treated basal cell or squamous cell skin cancer
- In situ cervical cancer
- Adequately treated stage I or II cancer currently in complete remission
- Any cancer from which the patient has been disease-free ≥ 5 years
- No advanced (grade 3-4) pre-existing neuropathy
- No HIV positivity
Data sourced from ClinicalTrials.gov (NCT00790647). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.