A total of 15 patients with refractory multiple myeloma (MM; 4 primary
unresponsive and 11 relapsed and resistant to re-induction/salvage th
erapy) received i.v. vincristine on day 1 and oral etoposide daily for
4 days, the treatment being repeated at 3-weekly intervals. The patie
nts were re-assessed after three cycles of chemotherapy, and non-respo
nders received no further therapy. There was no complete or partial re
sponse. A minimal response was seen in two patients, and two others sh
owed stable disease. None of the responses was sustained, and all pati
ents eventually had progressive disease. Tt is concluded that combinat
ion chemotherapy with vincristine and oral etoposide given by this sch
edule is unlikely to be of any value in refractory myeloma.