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• W2161990397 endingPage "128" @default.
• W2161990397 startingPage "113" @default.
• W2161990397 abstract "The prognosis for patients with multiple myeloma (MM) has not improved much since the introduction of alkylating agents almost 30 years ago (1, 2). Median survival is approximately 30-36 months and only 50 to 60% of previously untreated patients respond to melphalan and prednisone in conventional doses (3, 4). When unfavourable prognostic signs are present such as a high /32-microglobulin (/?2M), a high plasma cell growth fraction, a low serum albumin or plasmablastic morphology, survival is reduced to between 8 and 18 months (5-l 1). A large number of treatment combinations with melphalan, prednisone and one or more additional agents (including anthracyclines) have been explored and although combination therapy may increase response rate a survival advantage over standard melphalan with prednisone is hardly seen (12-I 8). Due to the lack of efficacy of conventional chemotherapy and while new drugs with major activity against myeloma cells are still awaited, currently available drugs have been used in innovative regimens using higher dosages. These new therapeutic approaches have ultimately proved to be crucial in the development of more effective treatment. In 1983, a pilot study with marked dose intensification of melphalan [High Dose Melphalan (HDM)] was introduced by McElwain and Powles (19). Continuous infusion of vincristine and doxorubicin combined with high dose oral dexamethasone (VAD) was reported in 1984 (20). This review focuses on studies of dose intensification primarily initiated by HDM with or without stem cell support and on the follow-up studies of VAD including the efforts to overcome drug resistance. Recent results with the biological response modifiers a-interferon and anti-interleukin-6 are also discussed." @default.
• W2161990397 created "2016-06-24" @default.
• W2161990397 creator A5030424335 @default.
• W2161990397 creator A5058429057 @default.
• W2161990397 date "1993-04-01" @default.
• W2161990397 modified "2023-09-25" @default.
• W2161990397 title "Advances in the treatment of multiple myeloma" @default.
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