MYELOMA DURING A DECADE - CLINICAL-EXPERIENCE IN A SINGLE-CENTER

One hundred and fifty-six patients with multiple myeloma were treated over a period of 12 years at St. Bartholomew's Hospital. The progress of the disease was affected in 96/156 patients (61%). Response was def ined as achieving a plateau of M component. A partial or complete resp onse was seen in 68/120 patients treated conventionally (56.5%), and i n 28/36 patients treated with high-dose therapy (77.7%). The median su rvival of the group as a whole was 20 months, with a 2-year survival o f just over 40%. In the 36 patients treated with high-dose therapy, me dian survival was 6 years, and in a small group who have had maintenan ce Interferon therapy, the median has not yet been reached. In a univa riate analysis, age, intensity of therapy, haemoglobin and creatinine levels were significant, but multivariate analysis showed that only ag e and intensity of therapy were independent predictors for survival. T he outlook for relapsed patients who showed progression of disease rem ains poor, but palliation was best achieved by steroid and Interferon in combination. Patients who achieve complete responses and are mainta ined on Interferon appear to be doing better both in terms of freedom from symptoms and in survival, and methods to enable an elderly popula tion to tolerate this form of therapy need to be explored.