title: Natural interferon-alpha in combination with melphalan/prednisone versus melphalan/prednisone in the treatment of multiple myeloma stages II and III: a randomized study from the Myeloma Group of Central Sweden.
abstract: Three hundred thirty-five previously untreated patients with multiple myeloma in clinical stages II and III entered a randomized trial comparing intermittent oral melphalan and prednisone (MP) therapy (n = 171) with MP in combination with natural (leukocyte-derived) alpha-interferon (MP/IFN) (n = 164). The treatment groups were comparable with regard to major prognostic factors. The response frequency was 42% in the MP group and 68% in the MP/IFN group (P < .0001). Eighty-five percent of IgA myelomas and 71% of Bence-Jones myelomas responded to MP/IFN compared with 48% and 27%, respectively, to MP treatment (P = .001). There was no difference in the overall survival between the two treatment groups. However, the survival of 72 patients with IgA or Bence-Jones myeloma randomized to receive MP/IFN was significantly longer (median 32 months) than that of 71 patients treated with MP (median 17 months) (p < .05). No statistically significant difference in response frequency (60% v 46%) or survival was found for patients with IgG myeloma. Hematologic toxicity, WHO grades III and IV, was higher in the MP/IFN group (48%) than in the MP group (33%) (P < .05) during the induction treatment period. Flulike syndrome was observed in 68% of patients receiving MP/IFN. The results show that MP/IFN is a well-tolerated treatment regimen, superior to MP for remission induction, and it improves significantly the overall survival for patients with IgA and Bence-Jones myelomas.
authors.affiliation: Department of Oncology (Radiumhemmet), Karolinska Hospital, Stockholm.
authors.forename: A
authors.initials: A
authors.lastname: Osterborg
authors.forename: M
authors.initials: M
authors.lastname: Björkholm
authors.forename: M
authors.initials: M
authors.lastname: Björeman
authors.forename: G
authors.initials: G
authors.lastname: Brenning
authors.forename: K
authors.initials: K
authors.lastname: Carlson
authors.forename: F
authors.initials: F
authors.lastname: Celsing
authors.forename: G
authors.initials: G
authors.lastname: Gahrton
authors.forename: G
authors.initials: G
authors.lastname: Grimfors
authors.forename: H
authors.initials: H
authors.lastname: Gyllenhammar
authors.forename: R
authors.initials: R
authors.lastname: Hast
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage* / Q000009:adverse effects; D008558:Melphalan / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000401:mortality; D009367:Neoplasm Staging; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects; D015996:Survival Rate
chemical_list: D016898:Interferon-alpha; D008558:Melphalan; D011241:Prednisone