Assessment of early paraprotein response to vincristine-doxorubicin-dexamethasone chemotherapy may help guide therapy in multiple myeloma.
Vincristine, doxorubicin and dexamethasone (VAD) are commonly used as the initial chemotherapy in myeloma patients prior to high-dose therapy and autologous stem cell transplantation. We reviewed monoclonal protein responses and survival of 62 patients treated in this way. Among patients with IgG paraprotein, achievement of at least 50% reduction in paraprotein after the first cycle of VAD correlated with significantly better event-free survival at 3 years, compared with those having less than 50% response. We postulate that early paraprotein response may be used to identify high risk patients.
Division of Haematology, Institute of Medical and Veterinary Science, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
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D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001536:Bence Jones Protein / Q000378:metabolism; D003907:Dexamethasone / Q000627:therapeutic use*; D004317:Doxorubicin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood / Q000188:drug therapy* / Q000401:mortality; D010266:Paraproteins / Q000378:metabolism*; D011379:Prognosis; D012307:Risk Factors; D033581:Stem Cell Transplantation; D014182:Transplantation, Autologous; D014750:Vincristine / Q000627:therapeutic use*
D007074:Immunoglobulin G; D010266:Paraproteins; D014750:Vincristine; D003907:Dexamethasone; D004317:Doxorubicin; D001536:Bence Jones Protein