RECOMBINANT INTERFERON-ALPHA2B AND HIGH-DOSE METHYL PREDNISOLONE IN RELAPSED AND RESISTANT MULTIPLE-MYELOMA

Twenty-one patients with refractory myeloma (10 primary resistant and 11 relapsed resistant) were treated with a combination of high dose me thyl prednisolone and recombinant interferon alpha2b (IFN-a2b). This t reatment included three megaunits/m(2) of IFN-a2b three times a week f or 12 weeks, plus 5-day pulsed high dose methyl prednisolone every 3 w eeks for two courses. A partial response (more than 50 per cent reduct ion in paraprotein) was observed in six patients; two of these had a g reater than 75 per cent reduction in paraprotein, and evaluation of bo ne marrow showed <5 per cent plasma cells. A minimal response (more th an 25 per cent reduction in paraprotein) was seen in four patients, gi ving an overall objective response rate of 10/21 (48 per cent). Subjec tive response, in terms of subsidence of pain and improvement of perfo rmance status, was seen in all patients who had adequate therapy. The protocol was generally well tolerated with minimal side-effects. There were 4/21 (19 per cent) treatment-related deaths which, though consid erable, was anticipated in such a study population. The excellent subj ective response seen supplements the objective response observed, and suggests a potential role for the combination of methyl prednisolone a nd IFN-a2b in refractory myeloma.