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Chemotherapy for resistant and relapsing multiple myeloma
Author(s) -
Alexanian Raymond,
Barlogie Bart,
Ventura Gerard
Publication year - 1989
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.1600-0609.1989.tb01507.x
Subject(s) - medicine , melphalan , cyclophosphamide , multiple myeloma , regimen , chemotherapy , total body irradiation , surgery , bone marrow , oncology , chemoradiotherapy
This report summarizes a broad experience in the treatment of patients with multiple myeloma resistant to standard chemotherapy. The VAD regimen has induced remissions in about 50% of relapsing patients but in only about 25% of previously unresponsive patients. In patients resistant to VAD, high‐dose therapies with intravenous melphalan, a CBV combination (cyclophosphamide‐BCNU‐VP‐16) or an EDAP regimen (VP‐16 ‐platinum) produced responses in about 40% of patients. However, these treatments usually required autologous bone marrow or blood stem cell support and the median duration of control was only 6 months. With an even more intensive program using high‐dose melphalan and total body irradiation supported by autologous bone marrow, all patients who survived the early treatment period responded for a median duration of about 1 year. Results indicated a dose‐response effect of chemoradiotherapy on VAD‐resistant myeloma with the potential that such intensive regimens will prolong disease‐free survival time.

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