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Refractory myelomatosis treated with mitoxantrone in combination with vincristine and prednisone (NOP‐regimen): a phase II study
Author(s) -
Gimsing Peter,
Bjerrum Ole W.,
Brandt Eystein,
Ellegaard Josrgen,
Evensen Stein A.,
Hansen Mogens Mosrk,
Hedenus Michael,
Hippe Erik,
Keldsen Nina,
Palva Ilmari,
Roudjer Stig,
Talstad Ingebrigt,
And Jan Westin,
Wislosff Finn
Publication year - 1991
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.1991.tb07951.x
Subject(s) - mitoxantrone , medicine , vincristine , refractory (planetary science) , regimen , prednisone , gastroenterology , chemotherapy , bolus (digestion) , surgery , cyclophosphamide , materials science , composite material
Summary. In a phase II study, patients with refractory myelomatosis were treated with a combination chemotherapy (NOP regimen): mitoxantrone (bolus injection of 4 mg/m 2 on days 1‐4), vincristine (continuous infusion of 0·4 mg/24h on days 1‐4) and prednisone (250 mg/d on days 1‐4 and 17‐20). The treatment was repeated every 4 weeks. Ninety‐two patients were treated after they were found refractory to treatment with melphalan and prednisone (and occasionally vincristine) ( n = 50) or more intensive treatment regimens ( n = 42) including anthracyclines ( n = 18). Response (≥ 50% reduction of M protein) was obtained in 23 patients and minor response (clinical improvement but less than 50% reduction in M protein) in 22 patients. The median duration of the response was 7·5 months. Equal response rates were observed irrespective of the type of previous treatment. The major toxicity was myelosuppression with severe granulocytopenia and infections. However, the frequency decreased throughout the cycles. The NOP treatment is recommended in refractory myelomatosis, especially in patients refractory to other intensive regimens. Patients in a poor clinical condition or with thrombocytopenia before treatment should have a reduced mitoxantrone dose in the first treatment cycles.