M-protein kinetics in multiple myeloma treated with melphalan, ifosfamide, prednisolone, nitrosourea and vincristine in combination.
Patients with multiple myeloma were treated chemotherapeutically with a combination of melphalan, ifosfamide, prednisolone, nitrosourea and vincristine (MIP-NV therapy). The M-protein kinetics during the course of MIP-NV therapy was studied. The kinetics of serum and urinary M-protein in the first cycle of the chemotherapy was classified into four patterns, and the mode of change in the M-protein level over the entire course of chemotherapy was classified into four prototypes. There were intimate relationships among M-protein kinetics patterns in the first cycle of the chemotherapy, the effect of the chemotherapy on M-protein reduction, maturity of myeloma cells, pretreatment labeling index and clinical stage of the disease. Moreover, analyzing the prototypes, it was found that both the time for maximum M-protein reduction and the rate of increase in the M-protein level after maximum M-protein reduction affected the survival time. To predict the effect of the chemotherapy on M-protein reduction and survival time, it was useful to analyze subgroups, which were classified according to the M-protein kinetics pattern in the first cycle, the time for maximum M-protein reduction and the rate of increase in the M-protein level after maximum M-protein reduction.
Ishii
H
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Second Department of Internal Medicine, Okayama University Medical School, Japan.
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000494:pharmacology* / Q000627:therapeutic use; D001798:Blood Proteins / Q000378:metabolism*; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage / Q000494:pharmacology; D007136:Immunoglobulins; D007700:Kinetics; D008558:Melphalan / Q000008:administration & dosage / Q000494:pharmacology; D009101:Multiple Myeloma / Q000188:drug therapy / Q000378:metabolism*; D009194:Myeloma Proteins / Q000378:metabolism*; D009607:Nitrosourea Compounds / Q000008:administration & dosage / Q000494:pharmacology; D011239:Prednisolone / Q000008:administration & dosage / Q000494:pharmacology; D014750:Vincristine / Q000008:administration & dosage / Q000494:pharmacology
D001798:Blood Proteins; D007136:Immunoglobulins; C009823:M-proteins (Myeloma); D009194:Myeloma Proteins; D009607:Nitrosourea Compounds; D014750:Vincristine; D011239:Prednisolone; D008558:Melphalan; D007069:Ifosfamide