RETRACTED ARTICLE: Bismuth adjuvant ameliorates adverse effects of high-dose chemotherapy in patients with multiple myel
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ORIGINAL ARTICLE
Bismuth adjuvant ameliorates adverse effects of high-dose chemotherapy in patients with multiple myeloma and malignant lymphoma undergoing autologous stem cell transplantation: a randomised, double-blind, prospective pilot study Per Boye Hansen 1,2
&
Milena Penkowa 3
Received: 28 June 2016 / Accepted: 5 December 2016 / Published online: 13 December 2016 # Springer-Verlag Berlin Heidelberg 2016
Abstract Purpose High-dose chemotherapy prior to autologous stem cell transplantation (ASCT) leads to adverse effects including mucositis, neutropenia and bacteremia. To reduce the toxicity, we treated myeloma and lymphoma patients with peroral bismuth as an adjuvant to chemotherapy to convey cytoprotection in non-malignant cells. Methods This trial was a prospective, randomised, doubleblind, placebo-controlled pilot study of hematological inpatients (n = 50) receiving bismuth or placebo tablets, in order to identify any potential superiority of bismuth on toxicity from chemotherapy. Results We show for the first time that bismuth significantly reduces grade 2 stomatitis, febrile neutropenia and infections caused by melphalan in multiple myeloma, where adverse effects also were significantly linked to gender. In lymphoma patients, bismuth significantly reduces diarrhoea relative to placebo. Also, lymphoma patients’ adverse effects were linked to gender. For the first time, bismuth is demonstrated as a safe strategy against chemotherapy’s toxicity without interfering with intentional anti-cancer efficiency. Also, we show how gender significantly influences various adverse effects and response to treatment in both multiple myeloma and malignant lymphomas.
* Per Boye Hansen [email protected]
1
Department of Hematology, Herlev Hospital, University of Copenhagen, 2720 Herlev, Denmark
2
Department of Hematology, University Hospital of Roskilde, DK-4000 Roskilde, Denmark
3
Section for Neuroprotection, Hjerneeksperten, 1718 Copenhagen, Denmark
Conclusion These results may impact clinical prevention of chemotherapy’s cytotoxicity in certain patient groups, and also, this study may direct further attention towards the impact of gender during the course and treatment outcome of malignant disorders. Keywords Stem cells . Neoplasm . Bismuth . Gender . Cytotoxicity
Introduction High-dose chemotherapy and autologous stem cell transplantation (ASCT) provide the first-line therapy for patients 37.5 °C), febrile neutropenia and documented infections according to Common Terminology Criteria for Adverse Events version 3.0 (CTCAE). The need for anti-infectious treatments and parenteral nutrition were registered along with duration of leukopenia, neutropenia and/or thrombocytopenia (defined as leukocytes
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