DPACE-based chemotherapy in the era of myeloma novel agents: a UK multicentre study.

The use of dexamethasone plus thalidomide in combination with a continuous infusion of cisplatin, doxorubicin, cyclophosphamide, and etoposide (DTPACE) was first described in relapsed myeloma (MM) and showed effectiveness as induction therapy before autologous stem cell transplant (ASCT)(1) . The addition of bortezomib to DTPACE (VTDPACE) led to improved outcomes(2,3) . Historical indications for DPACE-based therapies include salvage treatment of aggressive MM, plasma cell leukaemia, and initial presentation with extra-medullary disease. Infusional chemotherapy continues to play a role, especially as a bridge to ASCT or as a method of rapid tumour de-bulking(4) .