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Limited value of myeloablative therapy for late multiple myeloma
R Alexanian, M Dimopoulos, T Smith, K Delasalle, B Barlogie and R Champlin
University of Texas M.D. Anderson Cancer Center, Houston 77030.
The utility of myeloablative therapy supported by autologous bone marrow
(BM) or blood progenitor cells was assessed in 49 patients with multiple
myeloma who had received at least 1 year of prior chemotherapy. Outcomes
were compared with those of similar patients who did not receive intensive
treatment primarily for socioeconomic reasons. Among patients with disease
in resistant relapse despite treatment with vincristine-doxorubicin by
continuous infusion with pulse dexamethasone (VAD), a 61% response rate was
associated with a median remission time of 5 months. After primary
resistance for more than 1 year, 6 of 15 patients responded and the overall
survival was similar to that of control patients. For patients with
melphalan- resistant disease that responded to VAD, the remission time was
similar to that of control patients. Current myeloablative treatments
supported by autologous BM or blood stem cells were useful to very few
patients with multiple myeloma after the first year of chemotherapy.
Volume 83,
Issue 2,
pp. 512-516,
01/15/1994
Copyright © 1994 by The American Society of Hematology
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