TY - JOUR
T1 - Treatment of multiple myeloma with M-2 protocol and without maintenance therapy
AU - Paccagnella, Adriano
AU - Cartel, Giuseppe
AU - Fosser, Vinicio
AU - Salvagno, Luigi
AU - Bolzonella, Sandro
AU - Sileni, Vanna Chiarion
AU - Fiorentino, Mario V.
PY - 1993
Y1 - 1993
N2 - From September 1975 to December 1981, 63 consecutive untreated patients with multiple myeloma received the Lee M-2 protocol. We used the same drugs (melphalan, cyclophosphamide, vincristine, BCNU and prednisone) but employed the lowest suggested doses and recycled earlier, i.e. after 21-28 days. Thirty-five patients (62.5%) were in stage III, 16 (28.6%) in stage II and 5 (8.9%) in stage I. An objective response (reduction in paraprotein production rate > 50%) was obtained in 44 out of 56 cases (78%); 32 (57%) had a reduction > 75%. The median duration of response was 21.5 months. In responding patients the treatment was stopped after 1 yr and resumed only at relapse. Twenty-two out of 25 retreated patients are now evaluable. Eighteen of them (82%) responded again; in retreatment the degree of response was lower, but the duration of second response was only slightly lower than the first response (15.7 vs 21.5 months, NS). Of 7 patients receiving a third M-2 reinduction 4 responded again. The median survival for all the patients is 51 months. The high rate of second response to the M-2 regimen after an unmaintained remission brings into question the value of continuous therapy in responsive multiple myeloma.
AB - From September 1975 to December 1981, 63 consecutive untreated patients with multiple myeloma received the Lee M-2 protocol. We used the same drugs (melphalan, cyclophosphamide, vincristine, BCNU and prednisone) but employed the lowest suggested doses and recycled earlier, i.e. after 21-28 days. Thirty-five patients (62.5%) were in stage III, 16 (28.6%) in stage II and 5 (8.9%) in stage I. An objective response (reduction in paraprotein production rate > 50%) was obtained in 44 out of 56 cases (78%); 32 (57%) had a reduction > 75%. The median duration of response was 21.5 months. In responding patients the treatment was stopped after 1 yr and resumed only at relapse. Twenty-two out of 25 retreated patients are now evaluable. Eighteen of them (82%) responded again; in retreatment the degree of response was lower, but the duration of second response was only slightly lower than the first response (15.7 vs 21.5 months, NS). Of 7 patients receiving a third M-2 reinduction 4 responded again. The median survival for all the patients is 51 months. The high rate of second response to the M-2 regimen after an unmaintained remission brings into question the value of continuous therapy in responsive multiple myeloma.
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U2 - 10.1016/0277-5379(93)90002-M
DO - 10.1016/0277-5379(93)90002-M
M3 - Article
C2 - 6688993
AN - SCOPUS:0020517201
VL - 19
SP - 1345
EP - 1351
JO - European Journal of Cancer
JF - European Journal of Cancer
SN - 0959-8049
IS - 10
ER -