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Impact of concurrent gabapentin or pregabalin with high‐dose melphalan in patients with multiple myeloma undergoing autologous hematopoietic stem cell transplant

Melphalan is an alkylating agent used in both autologous (ASCT) and allogeneic stem cell transplantation. It is a substrate of L‐type amino acid transporter‐1 (LAT‐1) and LAT‐2, which are involved in its tissue penetration and elimination. Gabapentin and pregabalin, common concomitant medications in patients with multiple myeloma undergoing ASCT, are also substrates of LAT transporters, raising concern for potential competitive inhibition of melphalan transport. We evaluated whether concurrent use of gabapentin or pregabalin in patients receiving high‐dose melphalan (≥140 mg/m2) prior to ASCT impacted frequency and severity of melphalan‐related adverse events.