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Samarium Sm 153 Lexidronam Pentasodium and High-Dose Melphalan in Treating Patients With Multiple Myeloma Undergoing Stem Cell Transplant

This study has been completed.
National Cancer Institute (NCI)
Information provided by:
Mayo Clinic Identifier:
First received: January 15, 2008
Last updated: May 13, 2011
Last verified: May 2011

RATIONALE: Drugs used in chemotherapy, such as melphalan, work in different ways to stop the growth of cancer cells either by killing the cells or by stopping them from dividing. Samarium Sm 153 lexidronam pentasodium contains a radioactive substance that kill cancer cells. Peripheral blood stem cell transplant using stem cells from the patient may be able to replace immune cells that were destroyed by chemotherapy and radioactive drugs used to kill cancer cells.

PURPOSE: This phase I/II trial is studying the side effects and best dose of samarium Sm 153 lexidronam pentasodium when given together with high-dose melphalan in treating patients with multiple myeloma undergoing stem cell transplant.

Condition Intervention Phase
Multiple Myeloma and Plasma Cell Neoplasm Biological: sargramostim Drug: melphalan Procedure: autologous hematopoietic stem cell transplantation Procedure: peripheral blood stem cell transplantation Radiation: samarium Sm 153 lexidronam pentasodium Phase 1 Phase 2

Study Type: Interventional
Study Design: Primary Purpose: Treatment
Official Title: A Phase I/II Dose Escalation Study Assessing the Toxicity and Efficacy of 153-Samarium-EDTMP in Place of TBI in the Conditioning Regimen for PBSCT for Patients With Multiple Myeloma

Resource links provided by NLM:

Further study details as provided by Mayo Clinic:

Primary Outcome Measures:
  • Number of toxicity incidents (Phase I)
  • Proportion of successes (Phase II)

Secondary Outcome Measures:
  • Number of responses (Phase I)
  • Overall survival (Phase II)
  • Progression-free survival (Phase II)
  • Time to progression (Phase II)
  • Progressive disease variables

Estimated Enrollment: 76
Study Start Date: January 2000
Study Completion Date: July 2010
Primary Completion Date: June 2003 (Final data collection date for primary outcome measure)
Detailed Description:


  • To find the maximum tolerated dose of samarium Sm 153 lexidronam pentasodium when given with fixed high-dose melphalan as a conditioning regimen for autologous peripheral blood stem cell transplantation in patients with multiple myeloma. (Phase I)
  • To assess the response rates of this regimen in these patients. (Phase II)

OUTLINE: This is a phase I, dose-escalation study of samarium Sm 153 lexidronam pentasodium followed by a phase II study.

  • Phase I: Patients receive samarium Sm 153 lexidronam pentasodium IV once between days -14 and -10. Patients also receive melphalan IV on day -1. Patients undergo peripheral blood stem cell transplantation on day 0. Patients receive sargramostim (GM-CSF) subcutaneously once daily beginning on day 6 and continuing until blood counts recover.
  • Phase II: Patients receive samarium Sm 153 lexidronam pentasodium at the MTD determined in phase I .

Blood samples are collected periodically to determine clearance of samarium Sm 153 lexidronam pentasodium and bone marrow dosimetry.


Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No


  • Diagnosis of multiple myeloma requiring treatment
  • Must have at least 2 x 10^6 CD34+ cells collected for peripheral blood stem cell transplantation


Inclusion criteria:

  • ECOG performance status (PS) 0-2 (ECOG PS > 2 allowed if secondary to neuropathy or acute bone event)
  • Direct bilirubin ≤ 2.0 mg/dL
  • Alkaline phosphatase ≤ 750 μ/L
  • Creatinine ≤ 3.0 mg/dL
  • Ejection fraction ≥ 45%
  • Not pregnant or nursing
  • Negative pregnancy test
  • Fertile patients must use effective contraception for 6 months after the completion of study therapy

Exclusion criteria:

  • DLCO < 50%
  • FVC < 50%
  • FEV_1 < 50%
  • Active malignancy with the exception of nonmelanoma skin cancer
  • Uncontrolled infection
  • NYHA class III-IV cardiac disease


  • May or may not have received prior chemotherapy
  • At least 3 weeks since prior chemotherapy

    • Cyclophosphamide pulsing for stem cell collection allowed
  • At least 4 weeks since prior biologic therapy
  • At least 2 weeks since prior bisphosphonates and bisphosphonates maybe resumed 1 month post-study treatment
  Contacts and Locations
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Please refer to this study by its identifier: NCT00602706

Sponsors and Collaborators
Mayo Clinic
National Cancer Institute (NCI)
Study Chair: Angela Dispenzieri, MD Mayo Clinic
  More Information

Responsible Party: Angela Dispenzieri, M.D., Mayo Clinic Cancer Center Identifier: NCT00602706     History of Changes
Other Study ID Numbers: CDR0000582552
P30CA015083 ( U.S. NIH Grant/Contract )
MC9981 ( Other Identifier: Mayo Clinic Cancer Center )
1046-99 ( Other Identifier: Mayo Clinic IRB )
Study First Received: January 15, 2008
Last Updated: May 13, 2011

Keywords provided by Mayo Clinic:
refractory multiple myeloma
stage I multiple myeloma
stage II multiple myeloma
stage III multiple myeloma

Additional relevant MeSH terms:
Multiple Myeloma
Neoplasms, Plasma Cell
Neoplasms by Histologic Type
Hemostatic Disorders
Vascular Diseases
Cardiovascular Diseases
Blood Protein Disorders
Hematologic Diseases
Hemorrhagic Disorders
Lymphoproliferative Disorders
Immunoproliferative Disorders
Immune System Diseases
Samarium ethylenediaminetetramethylenephosphonate
Antineoplastic Agents, Alkylating
Alkylating Agents
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Myeloablative Agonists
Immunosuppressive Agents
Immunologic Factors
Physiological Effects of Drugs
Analgesics, Non-Narcotic
Sensory System Agents
Peripheral Nervous System Agents processed this record on July 19, 2017