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Controversy exists regarding the efficacy of various treatment schedules and drug combinations for patients with multiple myeloma. Fifty-three patients with this malignancy were evaluated. In a prospective program, 31 patients received a n intermittent combination drug schedule using melphalan and prednisone, and the results were compared to a group of 22 patients, studied retrospectively, who had been treated with continuous cyclophosphamide or melphalan administered to hematologic tolerance. Objective response occurred in 74% of those receiving the intermittent combination regimen compared to a 41% response rate for those receiving continuous alkylating agents. Eight patients who relapsed while on continuous alkylators were switched to the intermittent combination regimen, and three responded. Morbidity was not increased with intermittent combination drug program. EVERAL CHEMOTHERAPEUTIC AGENTS HAVE S been demonstrated to induce temporary remissions in multiple myeloma.4 When alkylating agents are employed, prolonged survival time has been shown to accompany clinical remission.11~~ Controversy regarding the efficacy of various therapeutic agents, treatment schedules, and drug combinations for this disease, however, c ~n t i n u e s . ~. ~J . ~J ~
George et al. (Thu,) studied this question.