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Potential value of vintristine‐adriamycin‐dexamethasone combination chemotherapy (VAD) in refractory and rapidly progressive myeloma
Author(s) -
Collin R.,
Greaves M.,
Preston F. E.
Publication year - 1987
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/j.1600-0609.1987.tb00758.x
Subject(s) - dexamethasone , medicine , refractory (planetary science) , multiple myeloma , chemotherapy , vincristine , concomitant , gastroenterology , oncology , cyclophosphamide , surgery , physics , astrobiology
10 patients with myeloma refractory to alkylating agents were treated with either 4‐d pulses of high‐dose dexamethasone therapy, or 4‐d pulsed high‐dose dexamethasone in combination with 4‐d continuous infusions of vincristine and adriamycin (VAD). 8 patients were evaluated after a median duration of treatment of 2.3 courses (range 1 to 4). 6 of the 8 evaluable patients achieved reduction in serum and/or urine paraprotein levels with a mean reduction in serum paraprotein of 74.1%. There was a concomitant improvement in wellbeing in these responding patients. 2 evaluable patients failed to show biochemical or clinical response (1 treated with VAD, 1 high‐dose dexamethasone). 2 patients currently survive 390 d and 180 d, respectively, on continuing therapy. 8 patients died with a mean duration of survival of 99 d (range 10 to 246 d). We conclude that the use of VAD chemotherapy in patients with refractory myeloma confers both a worthwile remission of disease symptoms and biochemical evidence of disease regression, and that trials of VAD as primary treatment for myeloma are indicated.