ORAL IDARUBICIN, DEXAMETHASONE AND VINCRISTINE (VID) IN THE TREATMENTOF MULTIPLE-MYELOMA

In order to replace the central venous line necessary for continuous i nfusion of vincristine and doxorubicin with high-dose dexamethasone (V AD) and to avoid hospitalization, we evaluated the efficacy and toxici ty of oral idarubicin, vincristine and dexamethasone (VID) in patients with multiple myeloma. Vincristine (1.6 mg/m(2), max 2 mg) was given as a bolus injection on day 1. Idarubicin was given in capsules 10 mg/ m(2)/day for days 1-4 with an intraindividual dose escalation, 40 mg d examethasone were given on days 1-4, 9-12, 17-20. Treatment cycles wer e repeated every 28 days. At this interim analysis, 53 patients have b een entered into the ongoing trial; 46 patients are evaluable for toxi city. The median age was 60 years (interquartile range, 52-65). 46% we re primary or secondary refractory, 20% had previously been treated wi th VAD and 30% had previously untreated disease, 4% had two or more re lapses. Four patients died within 2 months from entry and were conside red as early deaths (8.7%). 45% of the 42 patients evaluable for effic acy achieved a partial remission and 26% a minor remission. The median reduction of the M-component was 43% (interquartile range, 25-64%). V ID is an effective and convenient alternative to VAD even in relapsed or refractory patients.