Outpatient treatment of multiple myeloma with a combination of vincristine, Adriamycin and dexamethasone

Citation
G. Egerer et al., Outpatient treatment of multiple myeloma with a combination of vincristine, Adriamycin and dexamethasone, SUPP CARE C, 9(5), 2001, pp. 380-385
Citations number
22
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Health Care Sciences & Services
Journal title
SUPPORTIVE CARE IN CANCER
ISSN journal
0941-4355 → ACNP
Volume
9
Issue
5
Year of publication
2001
Pages
380 - 385
Database
ISI
SICI code
0941-4355(200107)9:5<380:OTOMMW>2.0.ZU;2-8
Abstract
Patients with relapsed multiple myeloma (MM) have been shown to respond to a combination therapy consisting of vincristine, Adriamycin (doxorubicin) a nd high-dose dexamethasone (VAD). Because of the low hematological toxicity of the VAD regimen, this combination is frequently chosen for tumor reduct ion prior to high-dose therapy and blood stem cell transplantation. This st udy was designed to examine the efficacy and complications of outpatient VA D treatment. Over a period of 6 years, 103 outpatients with MM were treated with VAD chemotherapy administered by microprocessor-controlled infusion p umps via intravenous polyurethane catheters equipped with a safety valve. R esponse to treatment, treatment-associated complications and infections wer e documented and analyzed. In 85 of the 103 patients, tumor reduction by mo re than 25% was found. In 8 patients an occlusion occurred as a result of k inking of the central venous catheter in the subcutaneous segment. In two t reatment cycles the infusions had to be stopped because of irreversible cat heter occlusion. Twenty patients were hospitalized because of complications , which were infectious in 12 and noninfectious in 8. Severe infectious com plications ( greater than or equal to WHO grade III) occurred in 5.6% of th e treatment cycles. Thus, continuous infusion of VAD over 96 h can be perfo rmed on an outpatient basis with a low complication rate.