CONVENTIONAL INDUCTION TREATMENTS DO NOT INFLUENCE OVERALL SURVIVAL IN MULTIPLE-MYELOMA

A retrospective analysis was performed on two subsequent myeloma patie nt series treated with the same conventional induction treatments, mel phalan and prednisone or alternating VMCP/VBAP: 273 were enrolled in t he multicentre M83 trial (M83 trial group) from 1983 to 1986; 160 were referred to a single institution (Haemat.To group) from 1986 to 1994. Response to treatment was Very similar in the two groups (53% v 50.3% ). Remission duration curves merely overlapped (median 20 v 21 months) . However, overall survival was significantly longer in the Haemat.To group (43.2 v 33 months, P < 0.04). This difference was due to a prolo nged period from relapse or progression to death (21 v 8 months, P < 0 .01; 20.8 v 7 months, P<0.009). Prolonged survival was also observed i n poor-prognosis patients with a serum beta(2)-microglobulin level > 3 mg/l, in the Haemat.To group (31.8 v 24.2 months, P < 0.04). The same induction treatments produced almost identical response rate and remi ssion duration in both groups, but overall survival was 10 months long er for one group. However, it could be argued that treatment salvage m odalities and support therapies have been improved in a decade. Lastly , induction treatments did not influence overall survival.