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Conventional chemotherapy in multiple myeloma.

J Westin1

  • 1Department of Medicine (Division of Hematology), University of Lund, Sweden.

Pathologie-Biologie
|April 8, 1999
PubMed
Summary

For multiple myeloma patients ineligible for stem cell transplants, standard melphalan and prednisone therapy offers survival comparable to combination chemotherapy. Alternative treatments like VAD exist for those resistant to alkylating agents.

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Area of Science:

  • Hematology
  • Oncology
  • Clinical Therapeutics

Background:

  • Multiple myeloma is a prevalent plasma cell malignancy primarily affecting the elderly.
  • Currently, no curative treatments exist for multiple myeloma.
  • Treatment goals focus on enhancing quality of life and extending non-progressive disease duration.

Purpose of the Study:

  • To review therapeutic strategies for multiple myeloma patients not candidates for high-dose chemotherapy with stem cell support.
  • To highlight established and alternative treatment regimens for this patient population.

Main Methods:

  • Review of existing therapeutic options for multiple myeloma.
  • Analysis of data from a large worldwide overview comparing treatment regimens.
  • Identification of alternative therapies for alkylating agent-refractory disease.

Main Results:

  • Intermittent melphalan and prednisone remains the standard induction therapy, demonstrating survival outcomes comparable to combination chemotherapy.
  • Vincristine, doxorubicin, and prednisone (VAD) or high-dose steroids are effective alternatives for patients refractory to alkylating agents.
  • Newer agents are under investigation but lack established therapeutic roles.

Conclusions:

  • Melphalan and prednisone provide a standard and effective induction therapy for multiple myeloma patients unsuitable for stem cell transplantation.
  • Established alternatives exist for managing alkylating agent resistance.
  • Ongoing research into novel agents may offer future treatment advancements.

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