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Plasma cell myeloma. An interpretive review
Author(s) -
Bergsagel D. E.
Publication year - 1972
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197212)30:6<1588::aid-cncr2820300626>3.0.co;2-y
Subject(s) - plasma cell myeloma , medicine , melphalan , procarbazine , multiple myeloma , cyclophosphamide , fibrosarcoma , oncology , prednisone , plasma cell , chemotherapy , cancer research , immunology , vincristine , pathology
Melphalan (M), cyclophosphamide (Cy), and BCNU are effective in the treatment of myeloma, producing objective improvement in a direct manifestation of the disease in 35 to 50% of patients, and prolonging survival to approximately 20 months from the start of therapy. Procarbazine is also effective, but the toxicity of prednisone for myeloma cells is questioned. Since the average myeloma tumor‐doubling time is about 6 months, the improved survival of myeloma patients associated with M treatment can be explained on the basis of a tumor cell kill of approximately one log. Mouse and human plasma cell tumors resistant to M have been shown to be sensitive to Cy, and concurrent M + BCNU, and M + Cy are synergistic against the KHT fibrosarcoma. The following approaches may improve treatment: 1. evaluate two, or more, alkylating agents administered sequentially, or concurrently; 2. test cycle‐specific agents after treatment with alkylating agents, and 3. use mouse myelomas resistant to M, Cy, and BCNU to screen new agents.