title: A comparison of polychemotherapy and melphalan/prednisone for primary remission induction, and interferon-alpha for maintenance treatment, in multiple myeloma. A prospective trial of the German Myeloma Treatment Group.
abstract: 406 untreated multiple myeloma patients of stage I (n = 54), II (n = 148) and III (n = 204) were enrolled in the trial. 51/54 stage I and 60/148 stage II patients were asymptomatic and followed without treatment until disease progression (progression free survival: 60% after 4 years for stage I versus 50% after 1 year for stage II). Symptomatic patients of stage I (n = 3/54) and II (n = 88/148) presenting with tumour progression, received melphalan 15 mg/m2 intravenously (i.v.) and prednisone 60 mg/m2 oral days 1-4 (MP). Stage II disease remission rate was 59%, and 50% tumour related survival (TRS) was 59 months. Stage III patients were randomised to receive MP or VBAMDex (vincristine/BCNU/doxorubicin/melphalan/dexamethasone) treatment. 43% of MP treated patients responded compared with 64% of the VBAMDex group. 50% TRS was 36 months in both groups without a detectable difference. 117 responders of stage II and III with stable disease were randomised to receive either IFN-alpha (5 x 10(6) IU, subcutaneous (S.C.) 3 times per week) or no maintenance treatment. The relapse rate in both groups was 50% after 13 months. No survival benefit for IFN alpha treated patients was observed (50% TRS: 45 months).
authors.affiliation: Abt. Immunologie und Transfusionsmedizin, Zentrum Innere Medizin und Dermatologie, Medizinische Hochschule Hannover, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Peest
authors.forename: H
authors.initials: H
authors.lastname: Deicher
authors.forename: R
authors.initials: R
authors.lastname: Coldewey
authors.forename: R
authors.initials: R
authors.lastname: Leo
authors.forename: R
authors.initials: R
authors.lastname: Bartl
authors.forename: H
authors.initials: H
authors.lastname: Bartels
authors.forename: H J
authors.initials: HJ
authors.lastname: Braun
authors.forename: W
authors.initials: W
authors.lastname: Fett
authors.forename: J T
authors.initials: JT
authors.lastname: Fischer
authors.forename: B
authors.initials: B
authors.lastname: Göbel
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002330:Carmustine / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D008297:Male; D008558:Melphalan / Q000008:administration & dosage; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality / Q000628:therapy*; D011241:Prednisone / Q000008:administration & dosage; D011446:Prospective Studies; D012074:Remission Induction; D015996:Survival Rate; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D016898:Interferon-alpha; D014750:Vincristine; D003907:Dexamethasone; D004317:Doxorubicin; D008558:Melphalan; D002330:Carmustine; D011241:Prednisone