Oral treatment regimen effective for relapsed multiple myeloma

Weekly cyclophosphamide and alternate-day prednisone are effective for patients with relapsed multiple myeloma after autologous stem cell transplantation, according to a report in the December Mayo Clinic Proceedings.

“There are cheap and well tolerated regimens available that are underutilized and likely as effective as newer more expensive regimens,” Dr. A. Keith Stewart from Mayo Clinic College of Medicine, Scottsdale, Arizona told Reuters Health.Dr. Stewart and colleagues at the University of Toronto investigated the efficacy and tolerability of weekly oral cyclophosphamide in combination with alternate-day prednisone as salvage therapy for 66 patients with relapsed multiple myeloma after autologous stem cell transplantation.Thirty-six of 59 evaluable patients (61%) responded to treatment, the authors report, including 24 patients with a partial response lasting a median 20.9 months and 12 patients with a minor response.The disease progressed after a median 20.2 months in 32 patients (54%), the results indicate, and 23 patients died a median 14.6 months after beginning oral treatment.The researchers estimate the median overall survival from the time of treatment initiation at 28.6 months; the one-year overall survival rate was 83%.The treatment regimen was well tolerated by most patients, the investigators note, and toxicities were generally minor.”This should be seen as a building block for combination therapies which incorporate newer agents, such as Velcade or Revlimid,” Dr. Steward said.Dr. Stewart added that patients who respond to this treatment should be treated “indefinitely, albeit at reduced doses of prednisone.”(Source: Mayo Clin Proc 2005;80:1578-1582: Reuters Health: Will Boggs, MD: January 2006.)