Improved survival of increased-risk myeloma patients on combined triple-alkylating-agent therapy: a study of the CALGB.

摘要: Two hundred fifty-two previously untreated evaluable patients with multiple myeloma were entered into a study testing regimen of three intravenous alkylating agents, melphalan, cyclophosphamide, and carmustine (BCNU), given in combination (BCMP) against employing oral melphalan (MP). Both regimens included tapering course prednisone. Objective responses based on the Myeloma Task Force criteria significantly more frequent group receiving BCMP. Survival for entire BCMP-treated was not better than that MP-treated (p = 0.62). However, when survival poor-risk (high tumor cell load) treated BCMP compared MP, an improvement attributable to therapy seen 0.049 0.02, respectively). In good-risk (low intermediate group, treatment resulted trend toward poorer survival, but this did achieve statistical significance 0.080 0.23, These results indicate optimal may be dependent extent disease at time first treatment. Additional studies explore effects intensity duration are needed order design improved patient's disease.