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Response rate, remission duration, and survival time were compared in 236 patients with multiple myeloma receiving a melphalan-prednisone-procarbazine combination and in 156 patients receiving only melphalan-prednisone. Response was confirmed when myeloma protein production had been reduced to less than 25% of the pretreatment value. Of the evaluable trials, 59% of patients responded to the procarbazine combination, and 48% to melphalan and prednisone. In both treatment groups, the survival time of all patients (22 months) and the remission duration of responding patients (21 months) were similar. Maximum degrees of myeloma protein reduction were associated with longer remissions and survival. Previously reported resistance to treatment of patients with only lambda Bence Jones protein was not apparent with these superior treatment regimens. Results support the value of combination chemotherapy with melphalan-prednisone-procarbazine for remission induction in patients with multiple myeloma.
Alexanian et al. (Tue,) studied this question.
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