Liposomal daunorubicin and dexamethasone as a treatment for multiple myeloma: the DD Protocol

Sao Paulo Medical Journal

Frederico Luiz Dulley¹  Rosaura Saboya¹  Vânia Tietsche De Moraes Hungria¹  Nadjanara Dorna Bueno¹  Fernando Gomes De Mello¹  Maria Tereza Frota¹  Carlos Sergio Chiattone¹  José Carlos Barros¹  Nair Sumie Mori¹  Daniel Sturaro¹  Maria Cristina Martins De Almeida Macedo¹  Roberto Luiz Da Silva¹  Leila Maria Magalhães Pessoa De Melo¹  Cármino Antonio Souza¹ 

[1] ,Hospital Sírio-Libanês

关键词: Multiple myeloma;    Daunorubicin;    Dexamethasone;    Drug therapy;    Drug toxicity;    Mieloma múltiplo;    Daunorrubicina;    Dexametasona;    Quimioterapia;    Toxicidade de drogas;   

DOI  :  10.1590/S1516-31802005000600003

来源: SciELO

【 摘 要 】

CONTEXT AND OBJECTIVE: Liposomal daunorubicin has been used to treat hematological malignancies, including multiple myeloma (MM). The goal was to evaluate efficacy, side-effects and toxicity of liposomal daunorubicin and dexamethasone ("DD Protocol"). DESIGN AND SETTING: Prospective study at Sírio-Libanês, São Camilo, Brasil and Alemão Oswaldo Cruz hospitals. METHODS: Twenty consecutive patients with active MM received four cycles of liposomal daunorubicin intravenously for two hours (25-30 mg/m²/day) on three consecutive days per month, with oral dexamethasone (10 mg every six hours) on four consecutive days three times a month. RESULTS: The male/female ratio was 1:1 and median age 60. Nine patients were stage IIA, ten IIIA and one IIIB. The median from diagnosis to starting DD was 13 months. All patients received four cycles, except one. Fifteen had already received chemotherapy before DD. Responses of > 50% reduction in serum monoclonal paraprotein were observed in six patients after first cycle (30%), six after second (30%) and four after third (20%), while four (20%) did not obtain this. Initially, 17 patients (85%) had anemia: 12 (70%) achieved correction. Progressive disease was observed in three patients (15%), while one had minimal response, four (20%) partial and 12 (60%) complete. Hematological toxicity was acceptable: three patients (15%) had neutrophils < 1,000/mm³; none had thrombocytopenia. Gastrointestinal toxicity was mild: nausea (10%), anorexia (15%) and no vomiting. CONCLUSIONS: This treatment has mild toxicity and good response rate. It may therefore be feasible before autologous bone marrow transplantation.

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