Pharmacokinetics and pharmacodynamics of high dose melphalan in myeloma patients undergoing an autograft [ 2006 - 2008 ]

Research Grant

Researchers: Dr Christa Nath (Principal investigator) ,  A/Pr Judith Trotman ,  Prof Peter Shaw

Brief description Myeloma is a cancer of the bone marrow that affacts over 1000 people every year in Australia. The treatment is difficult and toxic, particularly as patients who develop the disease are often older (typically 50-70 years) and have kidney problems as part of the disease. Most patients will have better control of their disease if they receive a high dose of a potent drug called melphalan. Melphalan is toxic to the bone marrow, so melphalan is followed by an infusion of the patients' bone marrow or blood stem cells (a bone marrow transplant). Dosing of melphalan is according to a standard schedule that does not account for individual factors. We know that the drug disappears from the blood quite quickly, and how quickly it disappears probably affects its toxicity and effectiveness. Higher doses are more toxic and patients can die as a result of their transplant, lower doses do not control the disease as well. Not many places in the world measure the levels of melphalan in the blood. At The Childrens Hospital we have already performed the largest study of melphalan bloods in children. With the formation of the NSW Bone Marrow Transplant Network, we have joined with doctors who treat adults with myeloma and realised that we were in a position to answer some major questions about the effectiveness of melphalan in myeloma and how important it was to get lower or higher levels of the drug in the patient's blood. We are planning what will be the largest study of melphalan blood levels in the world (more than 100 myeloma patients). By measuring the melphalan in their blood and then following what happens to the patients, we will be able to work out whether the dose of melphalan we are using is ideal; if there are things about the patient that tell us we should give a bigger or smaller dose and if the blood levels are related to how much toxicity the patient has after transplant and how well the myeloma is controlled. This should improve the outcome of myeloma patients.

Funding Amount $AUD 465,761.74

Funding Scheme NHMRC Project Grants

Notes New Investigator Grant