Evidence map›Paper›PMID 31791694›Full record

ArticleClinical lymphoma, myeloma & leukemia2020

Pharmacokinetics and Efficacy of Generic Melphalan Is Comparable to Innovator Formulation in Patients With Multiple Myeloma Undergoing Autologous Stem Cell Transplantation.

Aswin Anand Pai, Anup J Devasia, John Carl Panetta, Sathya Mani, Raveen Stephen Stallon Illangeswaran, Ezhilpavai Mohanan, Balaji Balakrishnan, Kavitha M Lakshmi, Uday Kulkarni, Fouzia N Aboobacker and 6 more

Erratum issuedOpen access · greenAbstract read
In one paragraph

Article in Clinical lymphoma, myeloma & leukemia, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.7field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Summary of the Highlights of 2019 ASTCT Meeting by iNDUS BMT Group at Chennai, India.Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion · 2019
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors at 2 institutions in 2 countries.

Aswin Anand PaiDepartment of Hematology, Christian Medical College, Vellore, India.
Anup J DevasiaDepartment of Hematology, Christian Medical College, Vellore, India.
John Carl PanettaDepartment of Pharmaceutical Sciences, St Jude Children's Research Hospital, Memphis, TN.
Sathya ManiDepartment of Hematology, Christian Medical College, Vellore, India.
Raveen Stephen Stallon IllangeswaranDepartment of Hematology, Christian Medical College, Vellore, India.
Ezhilpavai MohananDepartment of Hematology, Christian Medical College, Vellore, India.
Balaji BalakrishnanDepartment of Hematology, Christian Medical College, Vellore, India.
Kavitha M LakshmiDepartment of Hematology, Christian Medical College, Vellore, India.
Uday KulkarniDepartment of Hematology, Christian Medical College, Vellore, India.
Fouzia N AboobackerDepartment of Hematology, Christian Medical College, Vellore, India.
Anu KorulaDepartment of Hematology, Christian Medical College, Vellore, India.
Aby AbrahamDepartment of Hematology, Christian Medical College, Vellore, India.
Alok SrivastavaDepartment of Hematology, Christian Medical College, Vellore, India.
Vikram MathewsDepartment of Hematology, Christian Medical College, Vellore, India.
Biju GeorgeDepartment of Hematology, Christian Medical College, Vellore, India.
Poonkuzhali BalasubramanianDepartment of Hematology, Christian Medical College, Vellore, India. Electronic address: bpoonkuzhali@cmcvellore.ac.in.
Christian Medical College & Hospital · INSt. Jude Children's Research Hospital · US

Funding

DBT-Wellcome Trust India Alliance IA/CPHE/17/1/503351DBT-Wellcome Trust India Alliance IA/S/11/2500267DBT-Wellcome Trust India Alliance IA/S/15/1/501842Wellcome Trust
6 · The paper itself

Abstract

backgroundHigh-dose melphalan (MEL) is the standard conditioning regimen used for autologous stem cell transplantation (ASCT) in patients with multiple myeloma (MM). Generic MEL is routinely used in various transplant centers across the world including ours due to its reduced cost and ease of availability. We compared the pharmacokinetics (PK) and the clinical efficacy of generic MEL with that of the innovator formulation in MM patients undergoing ASCT. PATIENTS AND

methodsSixty-three patients diagnosed with MM receiving high-dose MEL were included in this study. MEL levels in plasma were measured using a liquid chromatography tandem mass spectrometry (HPLC/MS-MS) protocol and non-linear mixed effects modeling was used to evaluate the PK of the data.

resultsThe interindividual variability (IIV) in MEL area under the concentration versus time curve (AUC) and clearance (CL) were 4.39, 5.88-fold for generic, and 4.34, 6.85-fold for the innovator formulation, respectively. The median MEL AUC and CL were comparable between the 2 formulations. The population PK analysis showed age and creatinine CL as the only significant covariates explaining IIV in MEL AUC/CL. Analysis of MEL PK parameters with clinical outcome showed no significant differences in terms of onset and severity of mucositis, day to neutrophil and platelet engraftment, as well as response status on day 100 post ASCT between patients receiving generic or innovator formulations of MEL. In addition, neither MEL AUC nor CL was found to be associated with day +100 response.

conclusionOur study suggests that the PK and efficacy of the generic MEL is comparable to the innovator formulation.

Indexed as

AdultAgedAntineoplastic Agents, AlkylatingFemaleHematopoietic Stem Cell TransplantationHumansMaleMelphalanMiddle AgedMultiple MyelomaTransplantation, AutologousYoung AdultAntineoplastic Agents, AlkylatingMelphalanAutologous HSCTGeneric melphalanMultiple myelomaPopulation pharmacokinetics

Identifiers

PMID31791694
PMCPMC7115908
OpenAlexW2978480802

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.