Long-term control in a patient with refractory multiple myeloma by oral cyclophosphamide and dexamethasone

Prognosis of patients with multiple myeloma (MM) has substantially improved in recent years due to the incorporation of novel drugs into their treatment. However, older drugs should be kept in mind when modern drugs have failed.

We report on a 62-year-old female patient with high-risk, refractory light-chain myeloma who initially presented with acute renal failure and was consecutively treated with six different therapies without achievement of sustained disease control. Therapy of cyclophosphamide orally at 50 mg/day (100 mg twice a week) and dexamethasone at 24 mg once weekly was initiated, resulting in a very good partial response which was maintained for more than 21 months. Low-dose cyclophosphamide in combination with dexamethasone was well-tolerated and no significant hematological or nonhematological side-effects were noted.

We suggest that older drugs should be kept in mind as treatment options for patients with disease refractory to multiple therapies, including novel agents.