These findings were consistent with the patients history of. Peripheral stem cell transplantation plus combination chemotherapy in treating patients with multiple myeloma the safety and scientific validity of this study is the responsibility of the study sponsor and. Myeloma acronyms and abbreviations ig immunoglobulin im intramuscular shot or infection into the muscle. Much insight has been gained into the molecular pathways that lead to myeloma and indeed much more remains to be done. Multiple myeloma is seldom cured, although treatment can relieve symptoms, induce remission, and prolong life. It is synonymous with myeloma and plasma cell myeloma. Dcep in combination with thalidomide as salvage therapy. The changing paradigm patient case and question a 65yearold violinist is diagnosed with myeloma and receives revlimid, velcade, and dexamethasone rvd followed by highdose melphalan and stem cell transplantation and revlimid maintenance. This causes them to interfere with the production of normal blood cells.
Many core booklets and key medical articles are translated as well. Is dcep chemotherapy a viable bridge to definitive. Dcep dexamethasone, cyclophosphamide, etoposide, and cisplatin has proved to be an effective salvage therapy for refractoryrelapsed mm patients. Approvedbypathwayboardforhaematologicalmalignancies. Dcep dexamethasone, cyclophosphamide, etoposide, and cisplatin is an effective regimen for peripheral blood stem cell collection in multiple myeloma. Efficacy, toxicity and feasibility of a shorter schedule. Multiple myeloma ambassador program our special guest speakers kathleen and james jim bond jim. The development of her cutaneous and mucosal plasmacytomas, despite 4 cycles of rvd, was concerning for refractory disease, and the treatment regimen was switched to dexamethasone, cyclophosphamide, etoposide, and cisplatin dcep. Pdf the vaddcep sequence is an effective pretransplant. Dexamethasone, cyclophosphamide, etoposide, and cisplatin dcep is one of the salvage options, but there has been a lack of data on salvage dcep in patients with previous exposure to novel agents. Aug 30, 2017 multiple myeloma is a difficult diagnosis to make. The purpose of this study was to assess the efficacy and toxicity of dcep dexamethasone, cyclophosphamide, etoposide, cisplatin, as thirdline regimen in relapsed or refractory multiple myeloma.
Multiple myeloma in a young female presenting with. We use cookies to make interactions with our website easy and meaningful, to better understand the use of our services, and to tailor advertising. Dcep chemotherapy followed by a single, fixed dose of pegylated filgrastim allows adequate stem cell mobilization in multiple myeloma patients patrizia zappasodi from the division of hematology. Multiple myeloma is a rare type of cancer that initially has few or no symptoms. Treatment options for relapsed and refractory multiple myeloma. Its diagnosed and treated differently from multiple myeloma.
Dcep in combination with thalidomide as salvage therapy for post transplantation relapse the safety and scientific validity of this study is the responsibility of the study sponsor and. Mar 06, 2020 treatment protocols for multiple myeloma are provided below. Bortezomib plus dexamethasone is superior to vincristine. Request pdf daratumumab, bortezomib, and dexamethasone for multiple. Case report aggressive flc escape in a patient with igd myeloma. Sorry to hear that your transplant didnt have that much of an effect on your multiple myeloma.
A cancerous or malignant plasma cell is called a myeloma cell. Current multiple myeloma treatment adapted from the nccn guidelines diagnosis survival 35 yrs survival sep 20, 2005 inclusion criteria. Little is known, however, about its potential as mobilizing therapy. Relapsedrefractory, multiple myeloma, dcep, salvage. Multiple myeloma treatment regimens cancer therapy advisor. The pmmngs miles for myeloma 5k run walk event has been attended multiple times by the mayor of philadelphia, garners huge banners in the citys center, and attracts accomplished runners. Dcep and bendamustineprednisone as salvage therapy for quad and. May 18, 2018 the release cites an accurate number of new multiple myeloma cases more than 25,000year, but the lead phrase multiple myeloma is the second most common type of blood cancer in the united. Plasma cells make antibodies against infectious agents such as viruses and bacteria. Dcep dexamethasone, cyclophosphamide, etoposide, and cisplatin is an effective regimen for peripheral blood stem cell collection in multiple myeloma skip to main content thank you. Multiple myeloma treatment regimens part 1 of 9 clinical trials.
Recently diagnosed mm according to the criteria of the south west oncology group swog not previously treated, apart from local radiotherapy, in the case of a threatening or incapacitating lesion, andor a 4day block of dexamethasone 40 mgml in an emergency. Myeloma is a cancer of the plasma cells in the bone marrow, the spongy tissue inside of bones. Dcep dexamethasone, cyclophosphamide, etoposide, and. Dcep an alternative to standard regimen in myeloma. Dcep regimen buys time for multiple myeloma patients. The current treatment options for mm include watchful waiting for asymptomatic or smoldering multiple myeloma, chemotherapy, treatment with immune modulating medications, and stem cell transplantation. Request pdf dcep for relapsed or refractory multiple myeloma after therapy with novel agents multiple myeloma remains incurable despite the use of novel agents. Standardrisk multiple myeloma treatment options the treatment of standardrisk multiple myeloma depends partially on whether the patient is a candidate for transplant. Use of krdpace as salvage therapy in aggressive, relapsed.
Myeloma begins when healthy plasma cells in the bone marrow change and grow out of control. Multiple myeloma mm, also known as plasma cell myeloma and simple myeloma, is a cancer of plasma cells, a type of white blood cell that normally produces antibodies. Multiple myeloma is a cancer of the bone marrow plasma cells. Myeloma often damages the bone and is usually called multiple myeloma because. Peripheral stem cell transplantation plus combination. Multiple myeloma mm is a cancer of plasma cells in the bone marrow. Standard treatment for patients with multiple myeloma is debulking chemotherapy with nonalkylating agents followed by a regimen to mobilize peripheral blood stem cells pbsc and the transplantation. Dcep is an effective salvage treatment options for relapsed or refractory multiple myeloma in the setting of previous use of novel agents. Treatment was changed to dcep regimen, and daratumumab was added for primary refractory myeloma. Chisako ito, yoshinobu aisa, ai mihara and tomonori nakazato, lenalidomide is effective for the treatment of bortezomibresistant extramedullary disease in patients with multiple myeloma. I dont have any experience with the dcep regimen, but i do have a one question and one observation that may be helpful.
However, hematologic toxicities and trm were substantial, and concurrent use of prophylactic granulocytecolony. Treatment was changed to dcep regimen, and daratumumab was added for. Primary therapy induction for stem cell transplantation patients with relapse after transplant patients who are not transplant candidates general treatment recommendations. Aggressive relapsed and refractory extramedullary multiple myeloma is often treated with salvage infusional chemotherapy to achieve rapid disease control. Multiple myeloma is a type of blood cancer that affects the bone marrow, the bodys bloodforming system. Dcep is the acronym for a chemotherapy regimen used in the treatment of multiple myeloma d dexamethasone c cyclophosphamide cytoxan e etoposide vepesid p cisplatin platinol chemotherapy is often given as a combination of drugs. When plasma cells reproduce uncontrollably, two things happen. Dcep as a bridge to ongoing therapies for advanced relapsed. Dcep is the acronym for a chemotherapy regimen used in the treatment of multiple myeloma. It is associated with a poor prognosis and resistance to therapy and is often associated with highrisk cytogenetics. Normally, plasma cells produce antibodies and play a key role in immune function. There is limited data describing dexamethasone, cyclophosphamide, etoposide, and cisplatin dcep in relapsed refractory multiple myeloma rrmm. In conclusion, dcep, in addition to its demonstrated antitumor activity, is an effective regimen for mobilizing peripheral blood progenitor cells in myeloma patients, with little or no sideeffects. Dexamethasone, cyclophosphamide, etoposide and cisplatin.
Dcep as a bridge to ongoing therapies for advanced. These properties render dcep a useful regimen for the debulking and mobilization phase of highdose programs for multiple myeloma. Radiation therapy is a treatment that uses high doses of radiation to destroy cancer cells and shrink tumors. Pdf novel treatment strategies have remarkably improved the multiple myeloma mm patients survival, with associated increased costs. As maddie hunter explained, the miles for myeloma 5k run walk really has made the people of philadelphia familiar with myeloma. Pdf multiple myeloma in a young female presenting with. Apr 12, 2018 the combination of dexamethasone, cyclophosphamide, etoposide, and cisplatin dcep is an effective bridge to autologous stem cell transplant asct or novel agents in patients with relapsed refractory multiple myeloma. All are available free of charge online and in printed copy by mail. Letter to the editor to the editor anaplastic multiple myeloma amm is a very rare morphological subtype of multiple myeloma, which has been reported only sporadically, mostly in case reports. Efficacy, toxicity and feasibility of a shorter schedule of dcep regimen for stem cell mobilization in multiple myeloma skip to main content thank you for visiting. Multiple myeloma in a young female presenting with neurological.
Pdf management of multiple myeloma and usage of bortezomib. Efficacy of intensive salvage regimen vtdpace and dcep. Treatment of relapsedrefractory multiple myeloma rrmm presents a special therapeutic challenge, because of the heterogeneity of disease at relapse and the absence of clear biologicalbased. Commonly used regimens include dcep, cvad, and vtdpace. Erectile dysfunction is common among men of a certain age and also appears to be one of the more common myeloma side effects. Cancer therapy selection, dosing, administration, and the management of related adverse events can be a complex process that should be handled by an experienced healthcare team. Nov 16, 20 multiple myeloma remains incurable despite the use of novel agents. The changing paradigm patient case and question a 65yearold violinist is diagnosed with myeloma and receives revlimid, velcade, and dexamethasone rvd.
Multiple myeloma mm is an incurable plasma cell malignancy, in which aggressive relapses might require salvage cytotoxic infusional chemotherapy. Are you in need of the most current information about multiple myeloma. It affects many parts of the body hence its called multiple myeloma. Clodronate, pamidronate and zoledronic acid are all beneficial in myeloma.
In healthy people, plasma cells make up 23 % of the cells in the bone marrow. Find detailed drug treatment regimens for multiple myeloma. Report of 2 cases, clinical lymphoma myeloma and leukemia, 1, 83, 20. Dexamethasone, cyclophosphamide, etoposide and cisplatin dcep for relapsed or refractory multiple myeloma patients. The aim of this study was to evaluate the efficacy of dcep in mobilizing pbsc and to define its toxicity.
In addition to general treatment recommendations, treatment recommendations for the following are included. Recently, the introduction of newer agents such as. The combination of dexamethasone, cyclophosphamide, etoposide, and cisplatin dcep is an effective bridge to autologous stem cell transplant asct or novel agents in patients with relapsed refractory multiple myeloma. Based on how abnormal the plasma cells look under the microscope and the levels of immunoglobulins, some patients with smoldering multiple myeloma have a high risk of progressing to active myeloma. Each year in the united states, about 20,000 people learn they have this disease. Current multiple myeloma treatment adapted from the nccn. Myeloma is also known as multiple myeloma and refers to cancer that grows in plasma cells, a white blood cell that is made in the bone marrow, a material found in the center of large bones of the body. This case entails a young female with new diagnosis of multiple myeloma and. Sincere thanks to the fundraising efforts of the canadian myeloma community who make myeloma matter by helping to advance myeloma.
In this disease, the plasma cells a type of white blood cell become abnormal and multiply rapidly. In 2015, an estimated 28,850 new cases of multiple myeloma. How dcep chemotherapy is given and possible side effects. Patients and methods four hundred eightytwo patients were randomly assigned to vad n 121, vad plus dexamethasone, cyclophosphamide, etoposide, and cisplatin dcep consolidation n 121, bortezomib plus dexamethasone n 121, or bortezomib plus dexamethasone plus dcep. Pdf dcep dexamethasone, cyclophosphamide, etoposide. Lenalidomide is effective for extramedullary disease in. Dcep as a bridge to ongoing therapies for advanced relapsed and. Aggressive relapsed and refractory extramedullary multiple myeloma. The main emphasis is on recent scientific developments in all areas related to lymphoma, myeloma. The nccn recommends cancer patient participation in clinical trials as the gold standard for treatment. Although multiple myeloma affects the bones, it begins in plasma cells.
I have the impression that dcep typically is used as a bridging therapy. Dexamethasone, cyclophosphamide, etoposide and cisplatin dcep. This is a unique case of multiple myeloma in a young female that had failed firstline treatment but responded to targeted therapy of daratumumab. Cancer articles and journals intl myeloma foundation. Emergency physicians should suspect multiple myeloma based on pathologic fractures, back or bone pain at rest, normocytic anemia, and renal failure in an older patient. The understanding of these pathways is closely linked to their therapeutic implications and is stressed upon in the initial chapters. New painful nodules in a patient with multiple myeloma.
Supportive treatments for patients with multiple myeloma q. Home contact us for advertisers order publications disclaimer privacy policy site map copyright 2020. Some people with localized myeloma or bone pain that does not lessen with chemotherapy may receive radiation therapy to specific parts of the body. Your doctor will examine you and ask about your symptoms, medical history and overall health. Myeloma group this is a controlled document and therefore must not be changed or photocopied. Dcep as a bridge to ongoing therapies for advanced relapsed andor refractory multiple myeloma. Dexamethasone, cyclophosphamide, etoposide, and cisplatin called dcep q. Daratumumab, bortezomib, and dexamethasone for multiple myeloma. Initial studies 3 years ago showed 55% plasma cells in the bone marrow, hyperdiploidy, igg. American roentgen ray society images of multiple myeloma all images xrays echo and ultrasound ct images mri. Dcep chemotherapy followed by a single, fixed dose of. Dcep for relapsed or refractory multiple myeloma after. Erectile dysfunction in myeloma multiple myeloma center. Aggressive relapsed and refractory extramedullary multiple myeloma is often treated with salvage.
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