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 PetrucciLuigi Resegotti, Alessandro Pilerl, Franco Mandelli

Research output: Contribution to journalArticlepeer-review

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

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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