Melphalan treatment in patients with myelofibrosis with myeloid metaplasia
Between January 1985 and December 1992, 104 consecutive patients with symptomatic myelofibrosis with myeloid metaplasia (MMM) [splenic enlargement > 5 cm and/or transfusional requirement or Hb 20 × 109/l and/or platelets > 1·0 × 109/l] received low‐dose Melphalan (2·5 mg/3 times/week) to eval...
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| Veröffentlicht in: | British journal of haematology 2002-03, Vol.116 (3), p.576-581 |
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| creator | Petti, M. C. Latagliata, R. Spadea, T. Spadea, A. Montefusco, E. Aloe Spiriti, M. A. Avvisati, G. Breccia, M. Pescarmona, E. Mandelli, F. |
| description | Between January 1985 and December 1992, 104 consecutive patients with symptomatic myelofibrosis with myeloid metaplasia (MMM) [splenic enlargement > 5 cm and/or transfusional requirement or Hb 20 × 109/l and/or platelets > 1·0 × 109/l] received low‐dose Melphalan (2·5 mg/3 times/week) to evaluate the efficacy and toxicity of this approach. Among 99 evaluable patients, 66 (66·7%) achieved a response after a median time of 6·7 months: 26 (26·3%) had a normalization of all clinical and haematological parameters (complete response, CR) and 40 (40·4%) showed an improvement > 50% (partial response, PR). Thirty‐three patients (33·3%) were resistant. Reversible haematological toxicity was the most common complication. Median durations of CR and PR were 28·4 and 26 months respectively: median survival of CR + PR patients was 71·2 months (95%CI: 33·8–108·7) versus 36·5 months (95%CI: 24·5–48·5) for the non‐responders (log‐rank test, P = 0·002). In the multivariate analysis, the following variables were significantly associated with a shorter survival: anaemia [hazard risk (HR) = 2·7], WBC count > 20 × 109/l (HR = 2·4) and not achieving any type of response, either partial or complete (HR = 3·9). In conclusion, Melphalan could be a promising first‐line option for MMM patients with clinical or haematological symptoms requiring treatment. |
| doi_str_mv | 10.1046/j.0007-1048.2001.03331.x |
| format | Article |
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C. ; Latagliata, R. ; Spadea, T. ; Spadea, A. ; Montefusco, E. ; Aloe Spiriti, M. A. ; Avvisati, G. ; Breccia, M. ; Pescarmona, E. ; Mandelli, F.</creator><creatorcontrib>Petti, M. C. ; Latagliata, R. ; Spadea, T. ; Spadea, A. ; Montefusco, E. ; Aloe Spiriti, M. A. ; Avvisati, G. ; Breccia, M. ; Pescarmona, E. ; Mandelli, F.</creatorcontrib><description>Between January 1985 and December 1992, 104 consecutive patients with symptomatic myelofibrosis with myeloid metaplasia (MMM) [splenic enlargement > 5 cm and/or transfusional requirement or Hb < 10 g/dl and/or white blood cell (WBC) count > 20 × 109/l and/or platelets > 1·0 × 109/l] received low‐dose Melphalan (2·5 mg/3 times/week) to evaluate the efficacy and toxicity of this approach. Among 99 evaluable patients, 66 (66·7%) achieved a response after a median time of 6·7 months: 26 (26·3%) had a normalization of all clinical and haematological parameters (complete response, CR) and 40 (40·4%) showed an improvement > 50% (partial response, PR). Thirty‐three patients (33·3%) were resistant. Reversible haematological toxicity was the most common complication. Median durations of CR and PR were 28·4 and 26 months respectively: median survival of CR + PR patients was 71·2 months (95%CI: 33·8–108·7) versus 36·5 months (95%CI: 24·5–48·5) for the non‐responders (log‐rank test, P = 0·002). In the multivariate analysis, the following variables were significantly associated with a shorter survival: anaemia [hazard risk (HR) = 2·7], WBC count > 20 × 109/l (HR = 2·4) and not achieving any type of response, either partial or complete (HR = 3·9). In conclusion, Melphalan could be a promising first‐line option for MMM patients with clinical or haematological symptoms requiring treatment.</description><identifier>ISSN: 0007-1048</identifier><identifier>EISSN: 1365-2141</identifier><identifier>DOI: 10.1046/j.0007-1048.2001.03331.x</identifier><identifier>PMID: 11849213</identifier><identifier>CODEN: BJHEAL</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Science, Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Anemia - complications ; Antineoplastic agents ; Antineoplastic Agents, Alkylating - therapeutic use ; Biological and medical sciences ; blastic phase ; Chemotherapy ; Female ; Follow-Up Studies ; Hematology ; Humans ; Leukocyte Count ; Male ; Medical sciences ; Melphalan ; Melphalan - therapeutic use ; Middle Aged ; myelofibrosis with myeloid metaplasia ; Pharmacology. 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C.</creatorcontrib><creatorcontrib>Latagliata, R.</creatorcontrib><creatorcontrib>Spadea, T.</creatorcontrib><creatorcontrib>Spadea, A.</creatorcontrib><creatorcontrib>Montefusco, E.</creatorcontrib><creatorcontrib>Aloe Spiriti, M. A.</creatorcontrib><creatorcontrib>Avvisati, G.</creatorcontrib><creatorcontrib>Breccia, M.</creatorcontrib><creatorcontrib>Pescarmona, E.</creatorcontrib><creatorcontrib>Mandelli, F.</creatorcontrib><title>Melphalan treatment in patients with myelofibrosis with myeloid metaplasia</title><title>British journal of haematology</title><addtitle>Br J Haematol</addtitle><description>Between January 1985 and December 1992, 104 consecutive patients with symptomatic myelofibrosis with myeloid metaplasia (MMM) [splenic enlargement > 5 cm and/or transfusional requirement or Hb < 10 g/dl and/or white blood cell (WBC) count > 20 × 109/l and/or platelets > 1·0 × 109/l] received low‐dose Melphalan (2·5 mg/3 times/week) to evaluate the efficacy and toxicity of this approach. Among 99 evaluable patients, 66 (66·7%) achieved a response after a median time of 6·7 months: 26 (26·3%) had a normalization of all clinical and haematological parameters (complete response, CR) and 40 (40·4%) showed an improvement > 50% (partial response, PR). Thirty‐three patients (33·3%) were resistant. Reversible haematological toxicity was the most common complication. Median durations of CR and PR were 28·4 and 26 months respectively: median survival of CR + PR patients was 71·2 months (95%CI: 33·8–108·7) versus 36·5 months (95%CI: 24·5–48·5) for the non‐responders (log‐rank test, P = 0·002). In the multivariate analysis, the following variables were significantly associated with a shorter survival: anaemia [hazard risk (HR) = 2·7], WBC count > 20 × 109/l (HR = 2·4) and not achieving any type of response, either partial or complete (HR = 3·9). In conclusion, Melphalan could be a promising first‐line option for MMM patients with clinical or haematological symptoms requiring treatment.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anemia - complications</subject><subject>Antineoplastic agents</subject><subject>Antineoplastic Agents, Alkylating - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>blastic phase</subject><subject>Chemotherapy</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Hematology</subject><subject>Humans</subject><subject>Leukocyte Count</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Melphalan</subject><subject>Melphalan - therapeutic use</subject><subject>Middle Aged</subject><subject>myelofibrosis with myeloid metaplasia</subject><subject>Pharmacology. Drug treatments</subject><subject>Primary Myelofibrosis - blood</subject><subject>Primary Myelofibrosis - drug therapy</subject><subject>Prognosis</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><issn>0007-1048</issn><issn>1365-2141</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkE1Lw0AQhhdRbK3-BQmCx8SdbHY3OXjQotZS8aLnZZNM6IZ8mU1p--9NbLAePc3L8MwHDyEOUA9oIO5yj1Iq3T6Hnk8peJQxBt7uhEyBCe76EMApmf5CE3Jhbd6DjHI4JxOAMIh8YFOyfMOiWetCV07Xou5KrDrHVE6jO9NH62xNt3bKPRZ1ZuK2tuZvy6ROiZ1uCm2NviRnmS4sXo11Rj6fnz7mC3f1_vI6f1i5CacMXBGHmAqRppKlggoBlGHINM98X8sINEtTEUQJgo88DrhOkKHPEikSzAKQwGbk5rC3aeuvDdpO5fWmrfqTCqJQSJ_zAQoPUNL_bFvMVNOaUrd7BVQNDlWuBj1DDtXgUP04VLt-9Hrcv4lLTI-Do7QeuB0BbRNdZK2uEmOPHJOSRyHtufsDtzUF7v_9gHpcLobEvgGlyoyZ</recordid><startdate>20020301</startdate><enddate>20020301</enddate><creator>Petti, M. C.</creator><creator>Latagliata, R.</creator><creator>Spadea, T.</creator><creator>Spadea, A.</creator><creator>Montefusco, E.</creator><creator>Aloe Spiriti, M. A.</creator><creator>Avvisati, G.</creator><creator>Breccia, M.</creator><creator>Pescarmona, E.</creator><creator>Mandelli, F.</creator><general>Blackwell Science, Ltd</general><general>Blackwell</general><general>Blackwell Publishing Ltd</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope></search><sort><creationdate>20020301</creationdate><title>Melphalan treatment in patients with myelofibrosis with myeloid metaplasia</title><author>Petti, M. C. ; Latagliata, R. ; Spadea, T. ; Spadea, A. ; Montefusco, E. ; Aloe Spiriti, M. A. ; Avvisati, G. ; Breccia, M. ; Pescarmona, E. ; Mandelli, F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5031-6b8ed66dd73d6066103e83a5f22a791a3dd649ce12e5b45ace3e23c76cef41713</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anemia - complications</topic><topic>Antineoplastic agents</topic><topic>Antineoplastic Agents, Alkylating - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>blastic phase</topic><topic>Chemotherapy</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Hematology</topic><topic>Humans</topic><topic>Leukocyte Count</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Melphalan</topic><topic>Melphalan - therapeutic use</topic><topic>Middle Aged</topic><topic>myelofibrosis with myeloid metaplasia</topic><topic>Pharmacology. Drug treatments</topic><topic>Primary Myelofibrosis - blood</topic><topic>Primary Myelofibrosis - drug therapy</topic><topic>Prognosis</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Petti, M. C.</creatorcontrib><creatorcontrib>Latagliata, R.</creatorcontrib><creatorcontrib>Spadea, T.</creatorcontrib><creatorcontrib>Spadea, A.</creatorcontrib><creatorcontrib>Montefusco, E.</creatorcontrib><creatorcontrib>Aloe Spiriti, M. A.</creatorcontrib><creatorcontrib>Avvisati, G.</creatorcontrib><creatorcontrib>Breccia, M.</creatorcontrib><creatorcontrib>Pescarmona, E.</creatorcontrib><creatorcontrib>Mandelli, F.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>British journal of haematology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Petti, M. C.</au><au>Latagliata, R.</au><au>Spadea, T.</au><au>Spadea, A.</au><au>Montefusco, E.</au><au>Aloe Spiriti, M. A.</au><au>Avvisati, G.</au><au>Breccia, M.</au><au>Pescarmona, E.</au><au>Mandelli, F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Melphalan treatment in patients with myelofibrosis with myeloid metaplasia</atitle><jtitle>British journal of haematology</jtitle><addtitle>Br J Haematol</addtitle><date>2002-03-01</date><risdate>2002</risdate><volume>116</volume><issue>3</issue><spage>576</spage><epage>581</epage><pages>576-581</pages><issn>0007-1048</issn><eissn>1365-2141</eissn><coden>BJHEAL</coden><abstract>Between January 1985 and December 1992, 104 consecutive patients with symptomatic myelofibrosis with myeloid metaplasia (MMM) [splenic enlargement > 5 cm and/or transfusional requirement or Hb < 10 g/dl and/or white blood cell (WBC) count > 20 × 109/l and/or platelets > 1·0 × 109/l] received low‐dose Melphalan (2·5 mg/3 times/week) to evaluate the efficacy and toxicity of this approach. Among 99 evaluable patients, 66 (66·7%) achieved a response after a median time of 6·7 months: 26 (26·3%) had a normalization of all clinical and haematological parameters (complete response, CR) and 40 (40·4%) showed an improvement > 50% (partial response, PR). Thirty‐three patients (33·3%) were resistant. Reversible haematological toxicity was the most common complication. Median durations of CR and PR were 28·4 and 26 months respectively: median survival of CR + PR patients was 71·2 months (95%CI: 33·8–108·7) versus 36·5 months (95%CI: 24·5–48·5) for the non‐responders (log‐rank test, P = 0·002). In the multivariate analysis, the following variables were significantly associated with a shorter survival: anaemia [hazard risk (HR) = 2·7], WBC count > 20 × 109/l (HR = 2·4) and not achieving any type of response, either partial or complete (HR = 3·9). In conclusion, Melphalan could be a promising first‐line option for MMM patients with clinical or haematological symptoms requiring treatment.</abstract><cop>Oxford, UK</cop><pub>Blackwell Science, Ltd</pub><pmid>11849213</pmid><doi>10.1046/j.0007-1048.2001.03331.x</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Anemia - complications Antineoplastic agents Antineoplastic Agents, Alkylating - therapeutic use Biological and medical sciences blastic phase Chemotherapy Female Follow-Up Studies Hematology Humans Leukocyte Count Male Medical sciences Melphalan Melphalan - therapeutic use Middle Aged myelofibrosis with myeloid metaplasia Pharmacology. Drug treatments Primary Myelofibrosis - blood Primary Myelofibrosis - drug therapy Prognosis Survival Rate Treatment Outcome |
| title | Melphalan treatment in patients with myelofibrosis with myeloid metaplasia |
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