VAD REGIMEN IN THE TREATMENT OF RESISTANT MULTIPLE-MYELOMA - SLOW OR FAST INFUSION

The VAD regimen is effective in the treatment of resistant and relapsi ng multiple myeloma. In the original VAD regimen, vincristine (V) and doxorubicin (A) are given as continuous infusions together with perora l dexamethasone (D). For practical reasons, we have shortened the infu sion times: 8 hours for vincristine and 1 hour for doxorubicin. In thi s retrospective analysis, we have compared the efficacy and toxicity o f the original and modified VAD protocols in the treatment of myeloma patients at our institution. Of the 31 consecutive patients with myelo ma, primarily or secondarily resistant to alkylating agents, 16 were t reated by the original and 15 by the modified VAD protocol. We found n o significant difference in the response rates (good responses 31% and 20% respectively), survival times (17 and 9 months respectively) or t oxicity between the two protocols. VAD may well be modified so as to c onsist of short infusions of V and A. The overall efficacy of the trad itional and modified regimens is, however, rather unsatisfactory in pa tients with advanced myeloma.