title: High-dose chemoradiotherapy and autologous bone marrow transplantation for resistant multiple myeloma.
abstract: Seven patients with advanced multiple myeloma, refractory to therapy with alkylating agent-VAD (vincristine-adriamycin-dexamethasone), received a regimen combining high-dose melphalan with total body irradiation supported by autologous bone marrow transplantation. Very rapid, usually greater than 90% tumor mass reduction was achieved in six patients, regardless of prior chemotherapy responsiveness and marrow plasmacytosis up to 30%. Despite signs of early relapse in three patients (median remission duration of all patients, 15 months), five remain alive and well without further cytotoxic therapy from 2 to 21 months (median, 9+ months). Two patients died, one from surgical complications after transplantation and a second due to persistent neutropenia with fatal pneumonia. This treatment provides meaningful disease control for selected patients with resistant myeloma and a poor prognosis.
authors.forename: B
authors.initials: B
authors.lastname: Barlogie
authors.forename: R
authors.initials: R
authors.lastname: Alexanian
authors.forename: K A
authors.initials: KA
authors.lastname: Dicke
authors.forename: G
authors.initials: G
authors.lastname: Zagars
authors.forename: G
authors.initials: G
authors.lastname: Spitzer
authors.forename: S
authors.initials: S
authors.lastname: Jagannath
authors.forename: L
authors.initials: L
authors.lastname: Horwitz
mesh_terms: D001773:Blood Cells / Q000473:pathology; D016026:Bone Marrow Transplantation; D002452:Cell Count; D003131:Combined Modality Therapy; D006801:Humans; D008558:Melphalan / Q000008:administration & dosage* / Q000627:therapeutic use; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*
chemical_list: D008558:Melphalan