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No correlation between response and survival in patients with multiple myeloma treated with vincristine, melphalan,

L Baldini1, F Radaelli, O Chiorboli

  • 1Department of Hematology, Centro G. Marcora, Ospedale Maggiore IRCCS, Milan, Italy.

Cancer
|July 1, 1991
PubMed

Insights

This study evaluated the VMCP regimen for multiple myeloma, finding no direct link between treatment response and patient survival. Prognostic factors like myeloma cell mass and serum calcium impacted response, while elevated B2 microglobulin predicted shorter survival.

Area of Science:

  • Hematology
  • Oncology
  • Clinical Research

Background:

  • Multiple Myeloma (MM) is a hematologic malignancy.
  • Effective treatment strategies and prognostic indicators are crucial for patient outcomes.

Purpose of the Study:

  • To evaluate the prognostic significance of pretreatment characteristics in previously untreated multiple myeloma patients receiving the VMCP regimen.
  • To assess the correlation between therapeutic response and survival duration.

Main Methods:

  • A cohort of 85 previously untreated multiple myeloma patients (Durie Stages II and III) received the vincristine, melphalan, cyclophosphamide, and prednisone (VMCP) regimen.
  • Pretreatment characteristics were analyzed for their impact on therapeutic response (SWOG and TF criteria) and survival.
  • Multivariate analysis was employed to identify independent prognostic factors.

Main Results:

  • Therapeutic responses were observed in 31.2% (SWOG) and 68.7% (TF) of patients.
  • Response correlated inversely with myeloma cell mass, serum calcium, and bone status.
  • Median survival was 39 months for Stage II and 34 months for Stage III.
  • Serum B2 microglobulin ≥ 6 µg/ml was the sole unfavorable predictor of survival (risk = 2.79).
  • Therapeutic response did not significantly affect survival duration.

Conclusions:

  • No direct correlation was found between therapeutic response and survival in multiple myeloma patients treated with VMCP.
  • Inadequate response assessment criteria and the lack of curative treatments may contribute to the observed lack of correlation.
  • Elevated serum B2 microglobulin is a significant negative prognostic factor for survival in this patient group.

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