Intensive treatment of multiple myeloma and criteria for complete remission.
50 previously untreated patients with multiple myeloma received two-phase treatment: repeated cycles of 4 day infusion with vincristine, doxorubicin, and methylprednisolone (VAMP) followed by high-dose melphalan (HDM), with autologous bone marrow transplantation where possible. The overall response rate was 74% (37/50), with 25 patients (50%) achieving complete haematological and biochemical remission. These remissions were associated with a good quality of life as measured by performance status, pain grade, and the reversal of humoral immunosuppression. 6 patients died during the VAMP phase and there was 1 death related to HDM. The achievement of complete remission, as defined here, in such a high proportion of patients is exceptional and may represent a useful advance in the management of myeloma.
Gore
M E
ME
CRC Section of Medicine, Institute of Cancer Research, Sutton, Surrey.
Selby
P J
PJ
Viner
C
C
Clark
P I
PI
Meldrum
M
M
Millar
B
B
Bell
J
J
Maitland
J A
JA
Milan
S
S
Judson
I R
IR
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001798:Blood Proteins / Q000378:metabolism*; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D004317:Doxorubicin / Q000008:administration & dosage; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007136:Immunoglobulins; D008297:Male; D008558:Melphalan / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D008775:Methylprednisolone / Q000008:administration & dosage; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood / Q000628:therapy*; D009194:Myeloma Proteins / Q000378:metabolism*; D012074:Remission Induction / Q000379:methods; D013997:Time Factors; D014750:Vincristine / Q000008:administration & dosage
D001798:Blood Proteins; D007136:Immunoglobulins; C009823:M-proteins (Myeloma); D009194:Myeloma Proteins; D014750:Vincristine; D004317:Doxorubicin; D008558:Melphalan; D008775:Methylprednisolone