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<p>This retrospective, single‑center study evaluated the efficacy and safety of a reduced‑dose melphalan conditioning regimen (140–180 mg/m<sup>2</sup>) for autologous stem cell transplantation (ASCT) in patients with multiple myeloma (MM) ineligible for the standard dose (200 mg/m<sup>2</sup>). Clinical outcomes were compared between patients receiving reduced‑dose versus standard‑dose melphalan over a five-year period, with pre‑specified subgroup analyses based on age and renal function. The results demonstrated that despite less favorable baseline characteristics in the reduced-dose group, both overall survival (OS) and progression-free survival (PFS) met comparable criteria relative to the standard group. The reduced-dose regimen was associated with a significantly improved safety profile, characterized by lower rates of mucositis, fewer febrile episodes, and accelerated platelet engraftment. In conclusion, for MM patients unable to tolerate standard-dose conditioning, particularly those with compromised baseline status, a reduced-dose melphalan regimen offers a clinically effective and safer alternative that maintains therapeutic efficacy while reducing treatment-related toxicity.</p>

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Reduced dose versus standard melphalan conditioning for autologous stem cell transplantation in multiple myeloma: a single-center retrospective study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月6日

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  • Yifan Yao,
  • Shan Zhang,
  • Ziying Li,
  • Lili Luo,
  • Xuan Lu,
  • Huafang Wang

摘要

This retrospective, single‑center study evaluated the efficacy and safety of a reduced‑dose melphalan conditioning regimen (140–180 mg/m2) for autologous stem cell transplantation (ASCT) in patients with multiple myeloma (MM) ineligible for the standard dose (200 mg/m2). Clinical outcomes were compared between patients receiving reduced‑dose versus standard‑dose melphalan over a five-year period, with pre‑specified subgroup analyses based on age and renal function. The results demonstrated that despite less favorable baseline characteristics in the reduced-dose group, both overall survival (OS) and progression-free survival (PFS) met comparable criteria relative to the standard group. The reduced-dose regimen was associated with a significantly improved safety profile, characterized by lower rates of mucositis, fewer febrile episodes, and accelerated platelet engraftment. In conclusion, for MM patients unable to tolerate standard-dose conditioning, particularly those with compromised baseline status, a reduced-dose melphalan regimen offers a clinically effective and safer alternative that maintains therapeutic efficacy while reducing treatment-related toxicity.