CORTICOSTEROID IS NOT BENEFICIAL IN MULTIPLE-DRUG COMBINATION CHEMOTHERAPY FOR MULTIPLE-MYELOMA

In a randomised multicentre trial a combination of methylprednisolone, vincristine, lomustine, cyclophosphamide and melphalan (MOCCA) was co mpared with the same regimen omitting methylprednisolone after the fir st course (COLA) in previously untreated patients with multiple myelom a. The MOCCA arm showed a response rate of 72% among 79 patients and t he COLA arm a response rate of 60% among 59 patients. This difference was not statistically significant. The median survival time was 56 mon ths in the MOCCA arm and 61 months in the COLA arm. There was a slight increase of early deaths (within the first 6 months) in the MOCCA arm as compared with the COLA arm. We conclude that, in multidrug therapi es, the continuation of corticosteroid at conventional dosage beyond t he first course does not improve response rate or survival time in mul tiple myeloma.