[Therapy of refractory multiple myeloma. I. Monotherapy with glucocorticoids and combined cytostatic therapy]

Treatment of refractory myeloma is still a problem. For patients where treatment with melphalan and prednisone had no effect, many therapeutic procedures were suggested and tested. Some were more, others less successful. In the first part of this review the author summarizes clinical studies which evaluate the importance of glucocorticoids and various combinations of cytostatics administered in this indication. He considers a continual four-day infusion of vincristine and adriamycin or mitoxantrone with large doses of glucocorticoids the most effective treatment. In the primarily resistant form glucocorticoids are the most important component of treatment. Finally the author presents a review of therapeutic patterns. In the second part of the paper the author will deal with the therapeutic results of large doses of cytostatics, interferon and discuss experience with transplantation of bone marrow in patients with myeloma.