Phase II trial of high-dose melphalan and autologous bone marrow transplantation for metastatic XXXX .

@entity1 @entity137 @entity390 @entity3136 @entity882 @entity39 @entity5 @entity2910 @entity294 @entity391 @entity66 @entity3028 @entity14 @entity694 @entity360 @entity204 @entity1487
@entity694 , the second leading cause of @entity5 in the United States, is resistant to chemotherapy in a large majority of cases. Single-agent and combination chemotherapy have failed to prolong survival. New approaches are clearly needed. In experimental models, a steep dose-response curve for @entity14 has been demonstrated using various agents. The @entity137 of high-dose therapy with these drugs can be circumvented by autologous bone marrow transplantation. We investigated the use of high-dose melphalan with autologous bone marrow rescue in 20 @entity1 with metastatic @entity694 . Each @entity1 received melphalan, 180 mg/m2 intravenously (IV), followed eight hours later by bone marrow infusion. Median duration of @entity3028 (less than 500 neutrophils/microL) was twelve days (range, 5 to 35 days), while transfusion-dependent @entity882 (less than 20,000 platelets/microL) had a median duration of eight days (range, 3 to 23 days). Time to bone marrow engraftment was not affected by prior @entity1487 therapy. @entity390 and @entity391 occurred in 14 @entity1 but was generally short lived. Mild @entity3136 , @entity2910 , and @entity294 were common. Severe gastrointestinal (GI) side effects did not occur. One treatment-related @entity204 occurred secondary to intramural @entity39 , which resulted in massive @entity360 . Complete responses were observed in three @entity1 (15%) and partial responses in six @entity1 (30%), for an overall response rate of 45%. Median survival was 198 days in this group of @entity1 with @entity66 . High-dose melphalan therapy for metastatic @entity694 , when used with autologous bone marrow transplantation, appears to achieve a high response rate with tolerable @entity137 . Further investigation is needed to define the role of this therapy in the care of advanced @entity694 .
