Cytoxan is an older drug for multiple myeloma and it had been established as equally effective as melphalan in older studies. It remains a good and reatively non-toxic single drug option when the goal is to control the disease and maintain quality of life. Unlike anotehr foundational drug, melphalan, it does not damage the bone marrow and does compromise the possibility of a future bone marrow or self – stem cell transplantation. There are a number of published articles of its use in combination with thalidomide as well as Velcade. In 2011, NCCN added the combination of Velcade (bortezomib), cyclophosphamide (Cytoxan), and dexamethasone (Decadron) as an option for induction therapy for transplant candidates. For patients who have relapsed after previous therapy, two combinations have been added for salvage therapy: cyclophosphamide and dexamethasone with either Velcade or Revlimid.
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