Continuous low-dose cyclophosphamide-prednisone is effective and well tolerated in patients with advanced multiple myeloma.
BACKGROUND
Multiple myeloma is an incurable disease and after several lines of chemotherapy, patients enter a phase in which no standard treatment options are available. The poor outlook of these patients requires mild, palliative therapy with low toxicity. Previously used regimens either require frequent hospital attendance, lack efficacy or have significant toxicity.


METHODS
In the current study, daily low dose, oral cyclophosphamide (100 mg) and prednisone (10-20 mg; CP) were administered to patients with advanced myeloma. Forty-two patients with progressive disease after melphalan-based and VAD treatment were enrolled.


RESULTS
Objective responses were observed in 29 of 42 (69%) patients. In responding patients, median overall survival and progression-free survival were 22.2 months and 15.0 months, respectively. In non-responders, median OS was 3.5 months only. Side-effects were limited. Cytopenia was the most frequent event (8/29) prompting dose reduction. CP had to be stopped permanently in four patients (two cytopenia, two infections).


CONCLUSIONS
Orally administered, low dose continuous CP is a feasible, effective and well-tolerated regimen in the management of advanced multiple myeloma.
de Weerdt
O
O
Department of Haematology (G.03.647), University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
van de Donk
N W
NW
Veth
G
G
Bloem
A C
AC
Hagenbeek
A
A
Lokhorst
H M
HM
D000284:Administration, Oral; D000368:Aged; D000704:Analysis of Variance; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D003520:Cyclophosphamide / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000401:mortality; D009426:Netherlands / Q000453:epidemiology; D011241:Prednisone / Q000008:administration & dosage; D015996:Survival Rate
D003520:Cyclophosphamide; D011241:Prednisone