title: Timed-sequential high-dose cyclophosphamide and vincristine in the treatment of multiple myeloma.
abstract: BACKGROUND
  This study was designed to examine the efficacy and toxicity of high-dose cyclophosphamide (CY), and to evaluate the potential added effect of vincristine (VCR) given at a theoretic time of malignant cell stimulation in a group of patients with multiple myeloma, refractory to or relapsing after, treatment with standard doses of chemotherapy.
  
  
  METHODS
  Patients were randomly assigned to receive CY 2400 mg per M2 as a single-day dose and VCR 1.4 mg per M2 given on Day 1 or Day 9 after the CY.
  
  
  RESULTS
  There were 108 cases suitable for analysis. No difference in objective response (17.6%, 23.5%), subjective response, remission duration, or survival was observed in the two treatment arms.
  
  
  CONCLUSIONS
  The authors conclude that a single, high dose of cyclophosphamide is more toxic and provides equal or less response than the equivalent dose given over 4 consecutive days and that no improved effect was detected using timed-sequential therapy with VCR.
authors.affiliation: Johns Hopkins Oncology Center, Baltimore, MD 21205-2004.
authors.forename: R E
authors.initials: RE
authors.lastname: Lenhard
authors.forename: L A
authors.initials: LA
authors.lastname: Kalish
authors.forename: M M
authors.initials: MM
authors.lastname: Oken
authors.forename: D S
authors.initials: DS
authors.lastname: Ettinger
authors.forename: J
authors.initials: J
authors.lastname: Glick
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002453:Cell Cycle / Q000502:physiology; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy*; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D014750:Vincristine; D003520:Cyclophosphamide