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Carfilzomib was escalated at doses of 27, 36, 45, and 56\u2009mg\/m2 on days \u22126, \u22125, \u22122, and \u22121 before ASCT in the phase 1 component of the study. In addition, all the patients received melphalan 100\u2009mg\/m<jats:sup>2<\/jats:sup> on days \u22124 and \u22123. The primary endpoint of the phase 1 component was to identify the maximum tolerated dose, and the primary endpoint of the phase 2 component was the rates of complete response (\u2265CR) at 1 year after ASCT. The phase 1 dose escalation cohort included 14 patients, and 35 patients were included in the phase 2 cohort. The maximum tested dose was 56\u2009mg\/m<jats:sup>2<\/jats:sup> (MTD). The median time from diagnosis to study enrollment was 5.8 (range 3.4\u201388.4) months, and 16% of patients had obtained a \u2265CR prior to ASCT. The best response within 1 year after ASCT was a \u2265\u2009CR rate in 22% for the entire cohort, and 22% for patients treated at the MTD. The \u2265VGPR rates improved from 41% before ASCT to 77% by 1 year after ASCT. One patient had a grade 3 renal adverse event, and renal function returned to baseline with supportive care. The rate of grade 3\u20134 cardiovascular toxicity was 16%. The addition of carfilzomib to melphalan conditioning was safe and resulted in deep responses after ASCT.<\/jats:p>","DOI":"10.1002\/ajh.26990","type":"journal-article","created":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T09:38:51Z","timestamp":1687167531000},"page":"1277-1285","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A phase 1\/2 of carfilzomib and melphalan conditioning for autologous stem cell transplantation for multiple myeloma (<scp>CARAMEL<\/scp>)"],"prefix":"10.1002","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7201-4642","authenticated-orcid":false,"given":"Alissa","family":"Visram","sequence":"first","affiliation":[{"name":"Ottawa Hospital Research Institute University of Ottawa  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne R.","family":"Hayman","sequence":"additional","affiliation":[{"name":"Division of Hematology Mayo Clinic Rochester  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8780-9512","authenticated-orcid":false,"given":"Angela","family":"Dispenzieri","sequence":"additional","affiliation":[{"name":"Division of Hematology Mayo Clinic Rochester  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prashant","family":"Kapoor","sequence":"additional","affiliation":[{"name":"Division of Hematology Mayo Clinic Rochester  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martha Q.","family":"Lacy","sequence":"additional","affiliation":[{"name":"Division of Hematology Mayo Clinic Rochester  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3853-5196","authenticated-orcid":false,"given":"Morie A.","family":"Gertz","sequence":"additional","affiliation":[{"name":"Division of Hematology Mayo Clinic Rochester  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francis K.","family":"Buadi","sequence":"additional","affiliation":[{"name":"Division of Hematology Mayo Clinic Rochester  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Dingli","sequence":"additional","affiliation":[{"name":"Division of Hematology Mayo Clinic Rochester  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0240-0326","authenticated-orcid":false,"given":"Rahma","family":"Warsame","sequence":"additional","affiliation":[{"name":"Division of Hematology Mayo Clinic Rochester  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8573-9434","authenticated-orcid":false,"given":"Taxiarchis","family":"Kourelis","sequence":"additional","affiliation":[{"name":"Division of Hematology Mayo Clinic Rochester  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5335-9533","authenticated-orcid":false,"given":"Joselle","family":"Cook","sequence":"additional","affiliation":[{"name":"Division of Hematology Mayo Clinic Rochester  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9014-9658","authenticated-orcid":false,"given":"Moritz","family":"Binder","sequence":"additional","affiliation":[{"name":"Division of Hematology Mayo Clinic Rochester  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6890-969X","authenticated-orcid":false,"given":"Wilson","family":"Gonsalves","sequence":"additional","affiliation":[{"name":"Division of Hematology Mayo Clinic Rochester  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2210-2174","authenticated-orcid":false,"given":"Eli","family":"Muchtar","sequence":"additional","affiliation":[{"name":"Division of Hematology Mayo Clinic Rochester  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5651-1411","authenticated-orcid":false,"given":"Nelson","family":"Leung","sequence":"additional","affiliation":[{"name":"Division of Nephrology Mayo Clinic Rochester  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivek","family":"Roy","sequence":"additional","affiliation":[{"name":"Division of Hematology Mayo Clinic  Jacksonville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5862-1833","authenticated-orcid":false,"given":"S. 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