aclarubicin and Multiple-Myeloma

Fifty-two patients with progressive resistant multiple myeloma were entered in this Southwest Oncology Group Phase II study, using weekly intravenous Aclacinomycin A. Of forty-three evaluable patients for response, there was one partial remission of 2 years duration and two sustained clinical improvements with 25% reduction in paraprotein. Major toxicity seen was severe myelosuppression and significant nausea and vomiting requiring dose reduction and delay of the scheduled treatment. Cardiac arrhythmia was seen in one patient. Chronic daily schedule or continuous IV infusion is recommended for future study.

Topics: Aclarubicin; Aged; Drug Evaluation; Female; Humans; Male; Multicenter Studies as Topic; Multiple Myeloma; Remission Induction

Fourteen patients with multiple myeloma received aclarubicin (ACR) intravenous drip infusion at a dose of 15-25 mg/m2/day for 7 days every 3 weeks. Nine of the patients achieved more than a 25% reduction in M-protein. In two of the nine the reduction was more than 50% and the duration of their responses was 2.0 and 2.8 months, respectively. In the nine cases of previous combination chemotherapy-resistant multiple myeloma, five showed more than a 25% reduction and one of them showed more than a 50% reduction in M-protein. One of the two patients with tumors achieved a marked regression of the tumor mass and two of the 14 patients showed marked improvement in subjective symptoms. Hematological toxicity, anorexia, nausea and vomiting occurred frequently. However, no cardiac toxicity obviously attributable to ACR was detected, and alopecia was generally mild. Thus, the above results indicate that ACR may be useful in combination chemotherapy for multiple myeloma because of its effectiveness and relatively low dose-limiting factors.

Topics: Aclarubicin; Adult; Aged; Antibiotics, Antineoplastic; Antineoplastic Agents; Clinical Trials as Topic; Drug Resistance; Female; Humans; Immunoglobulins; Infusions, Parenteral; Male; Middle Aged; Multiple Myeloma; Naphthacenes; Neoplasm Staging

Fifteen patients with multiple myeloma received Aclarubicin (ACR) alone intravenously. Nine of fourteen patients (one patient with non-secretory myeloma was excluded) achieved more than a 25% reduction in M-protein (limited response = LR). Two of LR patients obtained more than a 50% reduction (good response = GR). The median total dose of ACR and the median time required to reach LR or GR were 210 mg and 28 days, respectively. One of two patients achieved a marked regression of tumor mass and two patients showed a remarkable improvement in subjective symptom. Hematological toxicities were frequently observed. However, cardiac toxicity was not detected and epilation was mild.

Topics: Aclarubicin; Aged; Clinical Trials as Topic; Female; Humans; Leukocyte Count; Male; Middle Aged; Multiple Myeloma; Naphthacenes

Although the occurrence of acute myeloid leukemia (AML) after chemotherapy for multiple myeloma (MM) is common in clinical settings, the simultaneous occurrence of these malignancies in patients without previous exposure to chemotherapy is a rare event. Etiology, disease management, and clinical treatment remain unclear for this particular occurrence. To the best of our knowledge, this study is the first to report a case of simultaneous presentation of AML and MM after exposure to ultraviolet irradiation.. We reported the case of a 73-year-old man (Han Chinese ethnicity) without previous medical history of AML and MM. The morphology and immunology of bone marrow cells confirmed the co-existence of AML and MM. Fluorescent in situ hybridization analysis of immunomagnetically separated abnormal plasma cells showed abnormal expression of the amplified RB-1, TP53, and CDKN2C (1p32). Cytogenetic analysis demonstrated Y chromosome deletion. After the patient was administered with bortezomib combined with cytarabine + aclarubicin + granulocyte colony-stimulating factor (CAG regimen), and evident curative effects were observed. The patient achieved and maintained complete remission for more than 6 months. Prior to the disease occurrence, the patient had received ultraviolet irradiation for 1 year and was detected with aberrant gene expression of RB-1, TP53, and CDKN2C (1p32). Nevertheless, the correlation of this phenomenon with the etiology of concurrent AML with MM remains unclear.. This study discussed the case of a patient diagnosed with AML concurrent with MM, who has no previous exposure to chemotherapy. This patient was successfully treated by bortezomib combined with CAG regimen. This study provides a basis for clinical treatment guidance for this specific group of patients and for confirmation of the disease etiology.

Topics: Aclarubicin; Aged; Antineoplastic Combined Chemotherapy Protocols; Cytarabine; Granulocyte Colony-Stimulating Factor; Humans; Leukemia, Myeloid, Acute; Male; Multiple Myeloma; Remission Induction

Topics: Aclarubicin; Aged; Cyclophosphamide; Female; Humans; Ifosfamide; Male; Middle Aged; Multiple Myeloma; Naphthacenes; Nitrosourea Compounds; Prednisolone; Procarbazine; Prognosis; Vincristine