IDARUBICIN, MELPHALAN AND CYCLOPHOSPHAMIDE - AN INTENSIFIED HIGH-DOSEREGIMEN FOR THE TREATMENT OF MYELOMA PATIENTS

Following conventional chemotherapy, eight myeloma patients presenting with advanced tumor stages were treated with an intensified high-dose regimen and autologous peripheral blood stem cell transplantation. Hi gh-dose chemotherapy consisted of idarubicin 20 mg/m(2) on days -13, - 12 and -11, melphalan 100 mg/m(2) on days -5 and -4 and cyclophosphami de 60 mg/kg (plus mesna 60 mg/kg) on days -3 and -2 (IMC). Seven patie nts achieved a complete remission or a very good partial remission (re duction of M-component greater than or equal to 90%). There were no to xic deaths. Severe mucositis and fever of unknown origin were seen in all patients. Reversible supraventricular tachycardias without clinica l signs of cardiac failure occurred in five patients. One patient deve loped a persistent deterioration of cardiac function. We surmise that high-dose chemotherapy with IMC is very effective and well tolerated i n myeloma patients.