Superior efficacy of MMCP regimen compared with VMCP and MMPP regimens in the treatment of multiple myeloma.
OBJECTIVE
A newly designed combination chemotherapy for multiple myeloma, MMCP [ranimustine (MCNU), melphalan (MPH), cyclophosphamide (CPM) and prednisolone (PSL)], was analyzed and compared with the results of our previous randomized trial of VMCP [vincristine, MPH, CPM and PSL] and MMPP [MCNU, MPH, procarbazine and PSL].


METHODS
MCNU (33.3 mg/m2, div) on day 1 and MPH (4 mg/m2, po), CPM (66.7 mg/m2, po) and PSL (30 mg/m2, po) from day 1 to 4, were administered. Each cycle was repeated every 3 weeks.


METHODS
From January 1991 until August 1995, 104 patients with multiple myeloma diagnosed at 10 hospitals of Nagoya Cooperative Study Group were enrolled.


RESULTS
Of the 87 evaluable patients, partial response rate for MMCP was 65.5% and was significantly higher than that of VMCP (13/47=27.7%, p<0.0001) and that of MMPP (21/47=44.7%, p=0.0196). A plateau attainment was observed in 49.4%. The percentage of the patients who attained plateau was significantly increased in the MMCP arm than in the VMCP arm (19.1 %, p=0.0017) but was not in comparison with that of MMPP arm (42.6%, p=0.6790). Patients treated with MMCP survived significantly longer than those treated with VMCP or MMPP (p=0.0009 by generalized Wilcoxon test, p=0.0023 by log-rank test) with median survival for MMCP being 31.6 months, for VMCP 22.5 months, and for MMPP 22.9 months. No significant differences were observed with respect to adverse effects among the three regimens.


CONCLUSIONS
The newly designed MMCP is a candidate as an induction chemotherapy for multiple myeloma.
Mizuno
Harumitsu
H
Department of Hematology, Social Insurance Chukyo Hospital, Nagoya.
Yamao
Hisami
H
Nagura
Eiichi
E
Shimizu
Kazuyuki
K
Kamiya
Osamu
O
Takeyama
Hideo
H
Nitta
Masakazu
M
Wakita
Atsushi
A
Ichikawa
Atsushi
A
Kobayashi
Masahide
M
Kawashima
Kohei
K
Saito
Hedehiko
H
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008558:Melphalan / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000401:mortality; D009607:Nitrosourea Compounds / Q000008:administration & dosage / Q000627:therapeutic use*; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D011241:Prednisone / Q000627:therapeutic use*; D011344:Procarbazine / Q000627:therapeutic use*; D012074:Remission Induction; D015996:Survival Rate; D016896:Treatment Outcome; D014750:Vincristine / Q000627:therapeutic use*
D009607:Nitrosourea Compounds; D011344:Procarbazine; D014750:Vincristine; D003520:Cyclophosphamide; D011239:Prednisolone; D008558:Melphalan; C020766:ranimustine; D011241:Prednisone