Balancing AEs With Improved Survival in Myeloma

When given before a stem cell transplant, busulfan plus melphalan, improved progression-free survival in patients with myeloma, but came with some extra adverse events.

A two-drug regimen of busulfan plus melphalan improved progression-free survival (PFS) in patients with myeloma who were undergoing an autologous hematopoietic stem cell transplant compared to those who received melphalan alone. However, this combination came with an extra dose of side effects, according to research presented by Lori Williams, PhD, APRN, AOCN, OCN, at the 2018 Oncology Nursing Society Annual Congress.

The two-drug regimens were given before transplant, and then patients were tracked for PFS after. Patients in the busulfan/melphalan arm had an average PFS of 64.7 months, compared to 34.4 months for patients who only received melphalan.

But, for the first 4 weeks after transplant, patients on the combination reported a higher symptom burden, that included sore mouth, sore throat, and mouth pain. After the first month or so, the number of patient-reported adverse events decreased for both groups, but still remained higher for the combination arm.