Role of Cytoxan in myeloma – pro
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 single drug palliative option. Unlike melphalan, it does not damage the bone marrow and has been used in patients for who autologous stem cell transplantation is a potential future option. 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 as options for salvage therapy. Both are combinations of cyclophosphamide and dexamethasone with either Velcade or Revlimid.
Gareth J. Morgan et al, Cyclophosphamide, thalidomide, and dexamethasone (CTD) as initial therapy for patients with multiple myeloma unsuitable for autologous transplantation Blood August 4, 2011 vol. 118 no. 5 1231-1238
Kenshi Suzuki Current Therapeutic Strategy for Multiple Myeloma Jpn J Clin Oncol 2013 0:hys215v1-hys215
Sagar Lonial, Induction Therapy for Newly Diagnosed Multiple Myeloma
J Natl Compr Canc Netw 2013 11:19-28
For Lay version see here
For more on autologous stem cell transplantation see here