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KMID : 0882419930450010002
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Korean Journal of Medicine
1993 Volume.45 No. 1 p.2 ~ p.11
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Combination Chemotherapy with Vincristine, Melphalan and Prednisone for Multiple Myeloma
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김태유
허대석/방영석/박선양/김병국/김노경/김효진
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Abstract
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ackground : The combination of melphalan and perdnisone has been the standard
therapy for multiple myeloma. However, owing to the emergence of the drug resistance,
essentially most patients have relapse or progression during chemotherapy. Vincristine was
reported to be albe to prevent the development of the resistance to melphalan.
Methods : Sixty two patients with multiple myeloma were treated with a combination
chemotherapy of vincristine, melphalan and prednisone (VMP). The regimen consists of
vincrstine 0.03 mg/kg I.v. (day 1), melphalan 0.1 mg/kg p.o.(day 1-7) and prednisone 1mg/kg
p.o. (day 1-7), which was repeated every four weeks.
Results : Among 51 evaluable patients, 29 patients (56%) achieved objective responses.
The median duration of response was 15 months. The median time to progression of overall
patients was 11 months. The factors influencing response were age (p<0.04) and performonce
status (p<0.03). The overall median surivival was 36 months. The single most important
factor associated with prolonged survival was the responsiveness to remission induction
chemotherapy (p<0.001). Leukopenia was observed in 42% and thrombocytopeni in 2%.
Neurotoxicity due to vincristine was found in 5.2% of the patients.
Conclusions : The VMP regimen was associated with relatively high response rate and
well tolerted, producing only mild bone marrow suppression and neurotoxicity. This result
shows that VMP combination chemomtherapy is an effective treatment regimen for multiple
myeloma.
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