1. Multiple myeloma: VMCP/VBAP alternating combination chemotherapy is not superior to melphalan and prednisone even in high-risk patients
- Author
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Boccadoro, M., Marmont, F., Tribalto, M., Awisati, G., Andriani, A., Barbui, T., Maria CANTONETTI, Carotenuto, M., Comotti, B., Dammacco, F., Frieri, R., Gallamini, A., Gallone, G., Giovangrossi, P., Grignani, F., Lauta, V. M., Liberati, M., Musto, P., Neretto, G., Petrucci, M. T., Resegotti, L., Pilerl, A., and Mandelli, F.
- Subjects
Melphalan ,Male ,Cancer Research ,Settore MED/06 - Oncologia Medica ,vincristine EMTREE medical terms: article ,THERAPY ,Middle Age ,priority journal MeSH:Aged ,Prednisone ,Antineoplastic Combined Chemotherapy Protocols ,Non-U.S. Gov't ,combination chemotherapy ,Combination chemotherapy ,Middle Aged ,Prognosis ,intravenous drug administration ,Oncology ,Vincristine ,SURVIVAL ,Female ,Support ,Multiple Myeloma ,medicine.drug ,medicine.medical_specialty ,Cyclophosphamide ,Urology ,Drug Administration Schedule ,medicine ,Humans ,Comparative Study ,human ,KINETICS ,Aged ,Carmustine ,VINCRISTINE ,business.industry ,Induction chemotherapy ,EMTREE drug terms:beta 2 microglobulin ,major clinical study ,Surgery ,carmustine ,cyclophosphamide ,doxorubicin ,melphalan ,prednisone ,female ,male ,multiple myeloma ,beta 2-Microglobulin ,Doxorubicin ,Human ,Support, Non-U.S. Gov't ,Regimen ,business ,Settore MED/15 - Malattie del Sangue - Abstract
The efficacy of alternating vincristine, melphalan (M), cyclophosphamide, prednisone/vincristine, carmustine, doxorubicin, and prednisone (VMCP/VBAP) polychemotherapy was compared with the M and prednisone (MP) regimen as induction treatment in multiple myeloma (MM). Three hundred four MM patients entered this study between March 1983 and July 1986; the analysis was performed in December 1989. The treatment groups did not show significant differences with respect to major prognostic factors. Median overall survival was 33.8 months. In the VMCP/VBAP and MP arms, after 12 induction chemotherapy cycles, 59.0% and 47.3% (P less than .068) of the patients achieved an M component reduction greater than 50%. No significant difference was observed in the two treatment arms in terms of remission duration (21.3 v 19.6 months, P less than .66) and survival (31.6 v 37.0 months, P less than .28). Patients younger than 65 years did not show any advantage from the alternating polychemotherapy. At diagnosis, the plasma cell labeling index (LI) and serum beta-2 microglobulin (beta 2-m) were evaluated in 173 and 183 patients, respectively. A significantly reduced survival was observed for patients with LI greater than or equal to 2% (16.4 months) or beta 2-m greater than or equal to 6 mg/L (20.4 months). Even in these poor-risk subgroups, VMCP/VBAP was not superior to MP.
- Published
- 1991