High-dose melphalan and autologous stem-cell transplant
Checked 2026-09-09
Transplant-eligible myeloma after induction
One cycle
single day × 1Components
| Drug | Dose | Route | Days | Note |
|---|---|---|---|---|
Melphalan Alkylating agent (nitrogen mustard) | 200 mg/m² (140 mg/m² if over 70 or renal impairment) | IV | D1 | day -2 or -1; stem cells reinfused day 0 |
Cycles
1 (tandem in selected high-risk patients)
1-day cycle
Emetogenicity
High (>90%)
G-CSF
Built into the protocol
Notes
- Followed by lenalidomide 10 mg maintenance (with daratumumab in PERSEUS) until progression.
Used in
Source
Reference doses for a typical adult from the cited protocol or label. Doses are adjusted for renal and hepatic function, age, performance status and prior toxicity, and institutional protocols vary. Verify against the current label and your local protocol before treating. Not medical advice.
Other regimens for these cancers
Pegylated liposomal doxorubicin
Platinum-resistant or partially platinum-sensitive ovarian cancer; Kaposi sarcoma
every 28 days
VRd
Newly diagnosed myeloma (with daratumumab as D-VRd in transplant-eligible patients)
every 21 days × 8
D-VRd (PERSEUS)
Newly diagnosed transplant-eligible myeloma: 4 induction cycles, ASCT, 2 consolidation cycles, then D-R maintenance
every 28 days × 4
DRd (daratumumab + lenalidomide + dexamethasone)
Newly diagnosed transplant-ineligible myeloma (MAIA); relapsed myeloma (POLLUX)
every 28 days
Lenalidomide maintenance
After autologous transplant
every 28 days
Teclistamab
Relapsed or refractory myeloma after 3 or more lines including a PI, IMiD and CD38 antibody
weekly