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D-PACE is an intensive combination chemotherapy regimen primarily used in the treatment of relapsed or refractory multiple myeloma and other plasma cell dyscrasias. The acronym stands for its constituent agents: dexamethasone (a corticosteroid), cisplatin (a platinum-based alkylating-like agent), doxorubicin (an anthracycline topoisomerase II inhibitor), cyclophosphamide (an alkylating agent), and etoposide (a topoisomerase II inhibitor). It is often used as a salvage therapy or as part of a mobilization strategy for stem cell collection. The regimen is typically administered as a continuous intravenous infusion over several days (often 96 hours) in a hospital setting due to its high toxicity profile, which includes significant myelosuppression and the risk of infection. D-PACE is frequently combined with other agents, such as proteasome inhibitors (e.g., carfilzomib or bortezomib) and immunomodulatory drugs (e.g., thalidomide or lenalidomide), in expanded regimens like VTD-PACE or CFZ-TD-PACE.
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