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Intensive sequential therapy for VAD-resistant multiple myeloma

M A Dimopoulos1, D M Weber, J Hester

  • 1University of Texas M.D. Anderson Cancer Center, Houston 77030.

Leukemia & Lymphoma
|May 1, 1994
PubMed
Summary
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This study shows that combining cyclophosphamide and etoposide is an effective rescue treatment for advanced multiple myeloma. This regimen improved response rates and survival in patients resistant to standard therapies.

Area of Science:

  • Hematology
  • Oncology
  • Clinical Research

Background:

  • Advanced multiple myeloma often becomes resistant to alkylating agents and VAD therapy.
  • Limited effective treatment options exist for patients with refractory disease.

Purpose of the Study:

  • To evaluate the efficacy of a combination regimen of cyclophosphamide and etoposide as a rescue treatment for advanced multiple myeloma.
  • To assess the feasibility of subsequent myeloablative therapy supported by autologous stem cell transplantation.

Main Methods:

  • Sixty-five patients with advanced, refractory multiple myeloma received cyclophosphamide and etoposide, followed by granulocyte-macrophage colony-stimulating factor (GM-CSF).
  • A subset of patients proceeded to myeloablative treatment with autologous bone marrow or blood stem cell support.

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Main Results:

  • The combination therapy achieved a 35% response rate with a 6% mortality rate.
  • Overall response rate, including those who received myeloablative treatment, reached 42%.
  • Median survival was 10 months, with a projected 18-month survival for selected patients.

Conclusions:

  • The combination of cyclophosphamide and etoposide is an effective salvage therapy for advanced multiple myeloma resistant to conventional treatments.
  • This approach facilitates early stem cell collection for potential myeloablative therapy in eligible patients.