Pretreatment protocol for autologous stem cell transplantation in multiple myeloma

  I. Indications.
  1. all patients with multiple myeloma
  2. in good physical condition
  3. good functional status of all organs
  II. Contraindications.
  Age greater than 70 years old
  III. Examination items.
  1. blood routine
  2. liver and kidney function
  3. electrolytes
  4. lactate dehydrogenase
  5. alkaline phosphatase
  IV. Preventive medication.
  1. Obey 8mg intravenously once before chemotherapy and once every 12 hours after chemotherapy, 4 times in total
  2. dexamethasone 8mg intravenous injection once before chemotherapy, once every 12 hours after chemotherapy, 4 times in total
  V. Drugs.
  Marfan
  VI. Dosage.
  200mg/per square meter of body surface area
  VII. Time of administration.
  1 day before stem cell infusion
  VIII. Method of administration.
  1. NS dilution
  2. 500ml of NS with a maximum of 225mg of Marfalan
  3. if more than 225mg, divide into 2 bottles of 500ml NS
  4. Each bottle must be dosed within 15-60 minutes to prevent drug degradation
  5. 2 novels should be hydrated before and after the use of mafran, 250ml of liquid per hour
  IX. Patients with renal insufficiency.
  1. creatinine clearance >= 50 (mL/min), mafran dose: 200mg/per square meter of body surface area
  2. creatinine clearance <50 (mL/min), mafran dose: 140mg/per square meter of body surface area
  X. Precautions.
  1. neutropenia: must be detected as soon as possible, treatment measures in place
  2. thrombocytopenia: platelet transfusion if necessary