title: Intensive treatment of multiple myeloma and criteria for complete remission.
abstract: 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.
authors.affiliation: CRC Section of Medicine, Institute of Cancer Research, Sutton, Surrey.
authors.forename: M E
authors.initials: ME
authors.lastname: Gore
authors.forename: P J
authors.initials: PJ
authors.lastname: Selby
authors.forename: C
authors.initials: C
authors.lastname: Viner
authors.forename: P I
authors.initials: PI
authors.lastname: Clark
authors.forename: M
authors.initials: M
authors.lastname: Meldrum
authors.forename: B
authors.initials: B
authors.lastname: Millar
authors.forename: J
authors.initials: J
authors.lastname: Bell
authors.forename: J A
authors.initials: JA
authors.lastname: Maitland
authors.forename: S
authors.initials: S
authors.lastname: Milan
authors.forename: I R
authors.initials: IR
authors.lastname: Judson
mesh_terms: 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
chemical_list: D001798:Blood Proteins; D007136:Immunoglobulins; C009823:M-proteins (Myeloma); D009194:Myeloma Proteins; D014750:Vincristine; D004317:Doxorubicin; D008558:Melphalan; D008775:Methylprednisolone