VAD chemotherapy as remission induction for multiple myeloma.
Anderson, Heather Scarffe, J Howard Ranson, Malcolm R Young, R Wieringa, Gilbert E Morgenstern, Godfrey R Fitzsimmons, Lesley Ryder, W David J
Anderson, Heather
Scarffe, J Howard
Ranson, Malcolm R
Young, R
Wieringa, Gilbert E
Morgenstern, Godfrey R
Fitzsimmons, Lesley
Ryder, W David J
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Abstract
A total of 142 patients with multiple myeloma received VAD as remission induction therapy. Seventy-five were previously untreated and 67 had relapsed (31) or refractory disease (36). Vincristine (total dose 1.6 mg) was infused with doxorubicin 36 mg m-2 by continuous ambulatory pump over 4 days. In addition, oral dexamethasone 40 mg day-1 was given for 4 days. Intermittent dexamethasone was only given to 19 patients. Courses were repeated every 21 days. The overall response rate was 84% [27% complete response (CR)] in previously untreated patients and 61% (3% CR) in patients with relapsed and refractory disease. The median survival was 36 months for untreated patients and 10 months for those who had received prior therapy. VAD was well tolerated; however, despite prophylaxis, 54% patients received antibiotics at some time during therapy and 37% had dyspepsia. Twenty-three patients subsequently received a transplant (eight allografts, eight marrow autografts and seven peripheral blood stem cell transplants). Eight have died-four in the allogeneic group and four in the autologous group. The overall median survival of transplanted patients has not yet been reached. VAD is an effective, out-patient therapy for inducing remission in multiple myeloma. Post-remission therapy needs to be optimised, but it is likely that the needs of previously untreated patients may be different from those with relapsed and refractory disease.
Description
Date
1995-02
Publisher
Collections
Keywords
Haematopoietic Stem Cell Transplantation
Type
Article
Citation
VAD chemotherapy as remission induction for multiple myeloma. 1995, 71 (2):326-30 Br. J. Cancer