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.
Yao et al. (Fri,) studied this question.