Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Reducing GI Toxicity After Melphalan/Auto-HSCT

Leuk Lymphoma; ePub 2018 Jan 2; Malek, et al

A cytoprotective agent appears to lower GI toxicity and maintain the efficacy of high-dose melphalan (HDM)/autologous hematopoietic cell transplantation (auto-HCT) in patients with multiple myeloma, according to an anlysis involving 221 individuals. Participants had multiple myeloma and were treated at either University Hospitals Cleveland Medical Center with amifostine (740 mg/m2 15 minutes before HDM; n=107) or MD Anderson Cancer Center without the agent. Among the results:

  • Amifostine was well tolerated with no significant adverse effects.
  • ≥Grade II oral mucositis occurred in 27% of patients pre-treated with amifostine, vs 47% of those who were not treated with the agent.
  • Nausea occurred in 32% and 86%, vomiting in 19% and 53%, and diarrhea in 56% and 73%, respectively.
  • Amifostine had no visible effect on engraftment, or progression-free or overall survival.


Malek E, Gupta V, Creger R, et al. Amifostine reduces gastro-intestinal toxicity after autologous transplantation for multiple myeloma. [Published online ahead of print January 2, 2018]. Leuk Lymphoma. doi:10.1080/10428194.2017.1408086.

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Tamibarotene vs. ATRA in APL, Source: Takeshita A et al. ASH 2017, abstract 642.

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Endoscopy for GI Bleeds in Severe Thrombocytopenia, Gastrointest Endosc; ePub 2018 Feb 1; Ramos, et al

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Must Reads in Myelodysplastic Syndrome

Undertreatment of Newly-Diagnosed MM Evaluated, Clin Lymphoma Myeloma Leuk; ePub 2018 Feb 3; Fakhri, et al

Blacks Fare Better After This Type of Transplant , Biol Blood Marrow Transplant.; ePub 2018 Jan 25; Solomon, et al

Medication Adherence’s Impact on Outcomes in MM , Clin Lymphoma Myeloma Leuk; ePub 2018 Feb 3; Gupta, et al

Predicting Long-Term Survival After Allo-HCT , Biol Blood Marrow Transplant; ePub 2018 Jan 21; Patel, et al

Advance Directives Underused in These Patients, Biol Blood Marrow Transplant; ePub 2018 Jan 23; Cappell, et al