Oral low-dose etoposide therapy for refractory multiple myeloma with extramedullary involvement

A 65-year-old man was hospitalized with IgG kappa-type multiple myeloma (MM) and enormous subcutaneous plasmacytomas. Two different combination chemotherapy regimens (MMCP and AVPP) and alpha-interferon therapy were ineffectual. Oral administration of etoposide at 50 mg/day was subsequently started, the tumors completely disappeared after 5 months. The blood level of monoclonal protein became undetectable after 8 months of continuous treatment. The side effect noted was loss of hair. The course in this patient suggests that long-term daily low-dose administration of etoposide should be attempted in patients with refractory MM and extramedullary plasmacytoma.