Multiple Myeloma and Plasma Cell Neoplasm Clinical Trial
Official title:
Interferon Maintenance in Advanced Multiple Myeloma After Using High-Dose Melphalan as Myeloablative Chemotherapy: A Pilot Study
RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing
so they stop growing or die. Peripheral stem cell transplantation may allow the doctor to
give higher doses of chemotherapy drugs and kill more tumor cells. Interferon alfa may
interfere with the growth of cancer cells.
PURPOSE: Phase II trial to determine the effectiveness of giving interferon alfa after
chemotherapy and peripheral stem cell transplantation to patients who have stage III or
stage IV multiple myeloma and who have been treated with high-dose melphalan.
OBJECTIVES: I. Determine the effectiveness of interferon alfa-2b maintenance following high
dose melphalan chemotherapy for patients with advanced multiple myeloma. II. Determine the
response rate to high dose dexamethasone therapy using sequential noncrossresistant
chemotherapies for patients with advanced multiple myeloma.
OUTLINE: Patients receive high dose dexamethasone on days 1-4, 9-12, and 17-20, followed by
4 weeks rest. Cyclophosphamide (CTX) is administered intravenously in combination with mesna
following dexamethasone therapy. Sargramostim (GM-CSF) is initiated subcutaneously 1 day
later and is continued for 10 days to support stem cell collections, which begin 10-14 days
after CTX induction. Following 4 weeks of rest, melphalan (L-PAM) is administered over 1
hour. Stem cell rescue is begun 48 hours after L-PAM therapy. Three to 4 months after the
first L-PAM course, a second L-PAM and stem cell rescue is undertaken. Interferon alfa-2b
(IFN-A) maintenance is administered 3 times per week following bone marrow recovery from the
first or second L-PAM courses. Patients achieving complete remission following the first
course of L-PAM may proceed directly to IFN-A maintenance. Patients achieving greater than
grade 3 nonhematologic toxicity or not achieving an absolute neutrophil count of greater
than 1,000/mm3 by day 21 posttransplant are not eligible for dose escalation.
PROJECTED ACCRUAL: A minimum of 30 patients will be enrolled.
;
Primary Purpose: Treatment
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