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High‐dose cyclophosphamide. An effective treatment for advanced refractory multiple myeloma
Author(s) -
Lenhard Raymond E.,
Oken Martin M.,
Barnes Janet M.,
Humphrey Richard L.,
Glick John H.,
Silverstein Murray N.
Publication year - 1984
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(19840401)53:7<1456::aid-cncr2820530705>3.0.co;2-c
Subject(s) - medicine , cyclophosphamide , refractory (planetary science) , regimen , multiple myeloma , bone marrow suppression , surgery , bone marrow , chemotherapy , gastroenterology , physics , astrobiology
The Eastern Cooperative Oncology Group evaluated cyclophosphamide 600 mg/m 2 intravenously daily × 4 (total dose each cycle 2400 mg/m 2 ) as an aggressive approach to the treatment of patients with advanced multiple myeloma. The overall objective response rate is 43%. This includes a 38% response rate for all previously treated patients and a 29% response rate for patients refractory to prior therapy with cyclophosphamide. The objective response duration was 3 months and the survival of responding patients 9 months. A subjective response rate of 63% was observed, characterized by effective pain relief and improved performance. Sixty‐nine percent of patients experienced leukocyte cell nadirs < 500/mm 2 with a mean time to marrow recovery of 17 days. Thrombocytopenia was less severe but required platelet transfusion in 43% of patients. Bone marrow toxicity was encountered in all patients, and death in aplasia is a significant risk. Strict adherence to entry criteria, and a systematic plan for hospitalization for antibiotic and blood component support is required for treatment with this regimen.