Multiple myeloma

VMCP/VBAP alternating combination chemotherapy is not superior to melphalan and prednisone even in high-risk patients

Mario Boccadoro, Fillppo Marmont, Maurizio Tribalto, Giuseppe Awisati, Alessandro Andriani, Tiziano Barbui, Maria Cantonetti, Mario Carotenuto, Benedetto Comotti, Franco Dammacco, Roberto Frieri, Andrea Gallamini, Gabriele Gallone, Piera Giovangrossi, Fausto Grignani, Vito Michele Lauta, Marina Liberati, Pellegrino Musto, Giorgio Neretto, Maria Teresa Petrucci & 3 others Luigi Resegotti, Alessandro Pilerl, Franco Mandelli

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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 <.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 <.66) and survival (31.6 v 37.0 months, P <.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 (β2-m) were evaluated in 173 and 183 patients, respectively. A significantly reduced survival was observed for patients with LI ≥ 2% (16.4 months) or β2-m ≥ 6 mg/L (20.4 months). Even in these poor-risk subgroups, VMCP/VBAP was not superior to MP.

Original languageEnglish
Pages (from-to)444-448
Number of pages5
JournalJournal of Clinical Oncology
Volume9
Issue number3
Publication statusPublished - 1991

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Melphalan
Prednisone
Combination Drug Therapy
Multiple Myeloma
Vincristine
Survival
Myeloma Proteins
beta 2-Microglobulin
Carmustine
Induction Chemotherapy
Plasma Cells
Doxorubicin
Cyclophosphamide
Therapeutics
Serum

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Boccadoro, M., Marmont, F., Tribalto, M., Awisati, G., Andriani, A., Barbui, T., ... Mandelli, F. (1991). Multiple myeloma: VMCP/VBAP alternating combination chemotherapy is not superior to melphalan and prednisone even in high-risk patients. Journal of Clinical Oncology, 9(3), 444-448.

Multiple myeloma : VMCP/VBAP alternating combination chemotherapy is not superior to melphalan and prednisone even in high-risk patients. / Boccadoro, Mario; Marmont, Fillppo; Tribalto, Maurizio; Awisati, Giuseppe; Andriani, Alessandro; Barbui, Tiziano; Cantonetti, Maria; Carotenuto, Mario; Comotti, Benedetto; Dammacco, Franco; Frieri, Roberto; Gallamini, Andrea; Gallone, Gabriele; Giovangrossi, Piera; Grignani, Fausto; Lauta, Vito Michele; Liberati, Marina; Musto, Pellegrino; Neretto, Giorgio; Petrucci, Maria Teresa; Resegotti, Luigi; Pilerl, Alessandro; Mandelli, Franco.

In: Journal of Clinical Oncology, Vol. 9, No. 3, 1991, p. 444-448.

Research output: Contribution to journalArticle

Boccadoro, M, Marmont, F, Tribalto, M, Awisati, G, Andriani, A, Barbui, T, Cantonetti, M, Carotenuto, M, Comotti, B, Dammacco, F, Frieri, R, Gallamini, A, Gallone, G, Giovangrossi, P, Grignani, F, Lauta, VM, Liberati, M, Musto, P, Neretto, G, Petrucci, MT, Resegotti, L, Pilerl, A & Mandelli, F 1991, 'Multiple myeloma: VMCP/VBAP alternating combination chemotherapy is not superior to melphalan and prednisone even in high-risk patients', Journal of Clinical Oncology, vol. 9, no. 3, pp. 444-448.
Boccadoro, Mario ; Marmont, Fillppo ; Tribalto, Maurizio ; Awisati, Giuseppe ; Andriani, Alessandro ; Barbui, Tiziano ; Cantonetti, Maria ; Carotenuto, Mario ; Comotti, Benedetto ; Dammacco, Franco ; Frieri, Roberto ; Gallamini, Andrea ; Gallone, Gabriele ; Giovangrossi, Piera ; Grignani, Fausto ; Lauta, Vito Michele ; Liberati, Marina ; Musto, Pellegrino ; Neretto, Giorgio ; Petrucci, Maria Teresa ; Resegotti, Luigi ; Pilerl, Alessandro ; Mandelli, Franco. / Multiple myeloma : VMCP/VBAP alternating combination chemotherapy is not superior to melphalan and prednisone even in high-risk patients. In: Journal of Clinical Oncology. 1991 ; Vol. 9, No. 3. pp. 444-448.
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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 <.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 <.66) and survival (31.6 v 37.0 months, P <.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 (β2-m) were evaluated in 173 and 183 patients, respectively. A significantly reduced survival was observed for patients with LI ≥ 2{\%} (16.4 months) or β2-m ≥ 6 mg/L (20.4 months). Even in these poor-risk subgroups, VMCP/VBAP was not superior to MP.",
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T2 - VMCP/VBAP alternating combination chemotherapy is not superior to melphalan and prednisone even in high-risk patients

AU - Boccadoro, Mario

AU - Marmont, Fillppo

AU - Tribalto, Maurizio

AU - Awisati, Giuseppe

AU - Andriani, Alessandro

AU - Barbui, Tiziano

AU - Cantonetti, Maria

AU - Carotenuto, Mario

AU - Comotti, Benedetto

AU - Dammacco, Franco

AU - Frieri, Roberto

AU - Gallamini, Andrea

AU - Gallone, Gabriele

AU - Giovangrossi, Piera

AU - Grignani, Fausto

AU - Lauta, Vito Michele

AU - Liberati, Marina

AU - Musto, Pellegrino

AU - Neretto, Giorgio

AU - Petrucci, Maria Teresa

AU - Resegotti, Luigi

AU - Pilerl, Alessandro

AU - Mandelli, Franco

PY - 1991

Y1 - 1991

N2 - 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 <.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 <.66) and survival (31.6 v 37.0 months, P <.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 (β2-m) were evaluated in 173 and 183 patients, respectively. A significantly reduced survival was observed for patients with LI ≥ 2% (16.4 months) or β2-m ≥ 6 mg/L (20.4 months). Even in these poor-risk subgroups, VMCP/VBAP was not superior to MP.

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