Mephalan in the treatment of multiple myeloma

Seventy-three patients with symptomatic multiple myeloma at Memorial Sloan-Kettering Cancer Center were treated with melphalan from 1963-1967. All patients but one were followed for three years or until their death. Of the 60 evaluable patients, 31 obtained no benefit, 20 patients had objective and subjective responses consistent with clear clinical benefit; 6 patients had subjective responses in the absence of objective change, and 3 patients had stabilization of their disease. Toxicity was tolerable. It was not possible to predict which patients would respond, utilizing clinical status, hematological status or protein excretion patterns (i.e., which type of light chain was produced). In previously untreated patients, survival from time of diagnosis is 21 months. The median survival of the melphalan responders (39 months) is longer than that for the patients with no response (15 months). These data will provide useful baseline material for the evaluation of future therapeutic trials in patients with multiple myeloma at this Center.