the author compared retrospectively two regimens. VMCBP regimen and VMP regimen for patients with multiple myeloma.
Botween Jan. 1979 and June 1984, 20 patients were treated with vincristine, melphalan, cyclophosphamide, BCNU, prednisone(VMCBP regimen), and between Jan. 1987 and May 1989,26 patients were treated with vincristine, melphalan, prednisone(VMP
regimen).
VMCBP regimen consist of vincristine 0.03mg/kg IV, day 1; melphalan 0.1mg/kg PO, day 1-7; cyclophosphamide 10mg/kg IV, day 1; BONU 0.5mg/kg IV, day 1; prednisone 1mg/kg PO, day 1-7.
And VMP regimen consist of vincristine 0.03mg/kg IV, day 1; melphalan 0.15mg/kg PO, day 1-7; prednisone 1mg/kg PO, day 1-7. Courses were repeated every 4 weeks. Treatment was continued until disease progression.
In 20 patients with VMCBP regimen, the response rate was 40%(8/20). In 26 patients with VMP regimen, the response rate was 69%(18/26). There was statistically significant difference (P<0.05) in response rate between two groups. Median duration of
response was 18 months in VMCBP group, and 11 months in VMP group. One year survival rate was 79% in VMCBP group, and 80% in VMP group. There was no statistically significant difference in remission duration and survival rate between two groups.
Both
regimen showed statistically significant survival difference between responders and nonresponders(p<0.01). In summary, VMP regimen showed better response rate than VMCBP regimen. But there was no statstically significant difference in remission
duration
and survival rate between two groups.
Randomized prospective phase III study will be tried.
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