title: Long-term control in a patient with refractory multiple myeloma by oral cyclophosphamide and dexamethasone.
abstract: BACKGROUND
  Prognosis of patients with multiple myeloma (MM) has substantially improved in recent years due to the incorporation of novel drugs into their treatment. However, older drugs should be kept in mind when modern drugs have failed.
  
  
  METHODS
  We report on a 62-year-old female patient with high-risk, refractory light-chain myeloma who initially presented with acute renal failure and was consecutively treated with six different therapies without achievement of sustained disease control. Therapy of cyclophosphamide orally at 50 mg/day (100 mg twice a week) and dexamethasone at 24 mg once weekly was initiated, resulting in a very good partial response which was maintained for more than 21 months. Low-dose cyclophosphamide in combination with dexamethasone was well-tolerated and no significant hematological or nonhematological side-effects were noted.
  
  
  CONCLUSIONS
  We suggest that older drugs should be kept in mind as treatment options for patients with disease refractory to multiple therapies, including novel agents.
authors: Department of Internal Medicine V (Hematology and Medical Oncology), Innsbruck Medical University, Innsbruck, Austria Laboratory of Tumor Biology and Angiogenesis, Innsbruck Medical University, Innsbruck, Austria.
authors: Normann
authors: N
authors: Steiner
authors: Department of Internal Medicine V (Hematology and Medical Oncology), Innsbruck Medical University, Innsbruck, Austria.
authors: David
authors: D
authors: Nachbaur
authors: Department of Internal Medicine IV (Nephrology and Hypertensiology), Innsbruck Medical University, Innsbruck, Austria.
authors: Paul
authors: P
authors: König
authors: Department of Internal Medicine V (Hematology and Medical Oncology), Innsbruck Medical University, Innsbruck, Austria.
authors: Wolfgang
authors: W
authors: Willenbacher
authors: Department of Internal Medicine V (Hematology and Medical Oncology), Innsbruck Medical University, Innsbruck, Austria Laboratory of Tumor Biology and Angiogenesis, Innsbruck Medical University, Innsbruck, Austria eberhard.gunsilius@i-med.ac.at.
authors: Eberhard
authors: E
authors: Gunsilius
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols; D003520:Cyclophosphamide / Q000008:administration & dosage*; D003907:Dexamethasone / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000473:pathology; D011379:Prognosis; D016879:Salvage Therapy; D013792:Thalidomide / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D013792:Thalidomide; D003907:Dexamethasone; D003520:Cyclophosphamide
keywords: Relapsed/refractory multiple myeloma; case report; cyclophosphamide; dexamethasone; old drugs; treatment options