Sa. Schey et al., The use of intravenous intermediate dose melphalan and dexamethasone as induction treatment in the management of de novo multiple myeloma, EUR J HAEMA, 61(5), 1998, pp. 306-310
The variable absorption of melphalan from the gastrointestinal tract result
s in response rates between 40 and 60%. High dose melphalan increases respo
nse rates but at the cost of increased morbidity and mortality. We have inv
estigated intravenous intermediate dose melphalan and dexamethasone in the
treatment of patients presenting with c-le novo multiple myeloma with the o
bject of reducing toxicity while preserving an improved response rate compa
red to oral melphalan and prednisolone. The results show that this treatmen
t can be delivered safely on an outpatient basis in patients up to the age
of 78 yr; 82% of patients achieved an objective response and 30% a complete
haematological and clinical remission. Median overall survival for the who
le group is 37 months.