[High-dose melphalan with stem cell support is now an established myeloma therapy. Treatment of myeloma from a 30-year perspective].
Melphalan and prednisone have been the backbone in myeloma therapy for more than 40 years. New developments in chemotherapy and supportive therapy, achieved during the two decades which preceded the use of high-dose chemotherapy with stem cell rescue, have not changed the overall prognosis. A study of high-dose melphalan with autologous stem cell support on 274 patients < 60 years, performed by the Nordic Myeloma Study Group, has shown a prolongation of the median survival by 1.5 years. The results confirm that this therapy is a major step forward in myeloma therapy. Cost-utility and quality-of-life studies show that high-dose therapy has acceptable costs and leads to a favorable long-term quality-of-life.
Hjorth
M
M
Sjukhuset i Lidköping, Skaraborgs Sjukhus. martin.hjorth@mailbox.swipnet.se
Lenhoff
S
S
Turesson
I
I
Westin
J
J
D000328:Adult; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant; D004305:Dose-Response Relationship, Drug; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007372:Interferons / Q000008:administration & dosage; D008558:Melphalan / Q000008:administration & dosage*; D009101:Multiple Myeloma / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery; D017410:Practice Guidelines as Topic; D011788:Quality of Life; D011859:Radiography; D012537:Scandinavian and Nordic Countries; D015996:Survival Rate; D014182:Transplantation, Autologous
D018906:Antineoplastic Agents, Alkylating; D007372:Interferons; D008558:Melphalan