Continuous low-dose cyclophosphamide-prednisone is effective and well tolerated in patients with advanced multiple myeloma

Background: Multiple myeloma is an incurable disease and after several line s of chemotherapy, patients enter a phase in which no standard treatment op tions are available. The poor outlook of these patients requires mild, pall iative therapy with low toxicity, Previously used regimens either require f requent hospital attendance, lack efficacy or have significant toxicity. Methods: In the current study. daily low dose, oral cyclophosphamide (100 m g) and prednisone (10-20 mg; CP) were administered to patients with advance d myeloma. Forty-two patients with progressive disease after melphalan-base d and VAD treatment were enrolled. Results: Objective responses were observed in 29 of 42 (69%) patients. In r esponding patients, median overall survival and progression-free survival w ere 22.2 months and 15.0 months. respectively. In non-responders, median OS was 3.5 months only. Side-effects were limited. Cytopenia was the most fre quent event (8/29) prompting dose reduction. CP had to be stopped permanent ly in four patients (two cytopenia, two infections). Conclusion: Orally administered. low dose continuous CP is a feasible. effe ctive and well-tolerated regimen in the management of advanced multiple mye loma. (C) 2001 Published by Elsevier Science B.V.