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Multiple myeloma: VMCP/VBAP alternating combination chemotherapy is not superior to melphalan and prednisone even in high-risk patients
- Source :
- Scopus-Elsevier
- Publication Year :
- 1991
-
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.
- 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
Subjects
Details
- ISSN :
- 0732183X
- Volume :
- 9
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Journal of clinical oncology : official journal of the American Society of Clinical Oncology
- Accession number :
- edsair.doi.dedup.....0bacae078bbf7ff2c32010b350da41d3