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Primary dexamethasone treatment of multiple myeloma
R Alexanian, MA Dimopoulos, K Delasalle and B Barlogie
University of Texas M.D. Anderson Cancer Center, Houston 77030.
Intermittent courses of dexamethasone (DEX) were administered to 112
consecutive, previously untreated patients with multiple myeloma (MM).
Using criteria based on a 75% or greater reduction of calculated tumor
mass, the overall response rate was 43%. Among comparable patients,
response rate were approximately 15% less than those observed previously
with vincristine-doxorubicin by continuous infusion with intermittent DEX
(VAD) and similar to those with melphalan-prednisone. The projected
survival times with VAD or DEX were similar. Results indicated that DEX
accounted for most of the plasma cell reduction achieved with VAD. Serious
complications occurred in 27% of patients treated with VAD, but in only 4%
of those who received DEX. In view of the similar outcome with fewer
serious complications, DEX provided a simple, effective, and safe primary
treatment for a large fraction of patients with MM. Patients who appear
most likely to benefit include those with hypercalcemia or pancytopenia, or
who require simultaneous radiotherapy for a pathologic fracture.
Volume 80,
Issue 4,
pp. 887-890,
08/15/1992
Copyright © 1992 by The American Society of Hematology
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