MAINTENANCE THERAPY WITH ALPHA-INTERFERON FOLLOWING FIRST-LINE VAD INMULTIPLE-MYELOMA

The aim of this study was to evaluate the response characteristics of vincristine, adriamycin and dexamethasone (VAD) as a first-line chemot herapy and to determine the efficacy of maintenance alpha-interferon ( alpha-IFN) in multiple myeloma (MM). Between January 1985 and December 1994, a prospective trial was performed in stage II and III MM patien ts. The study population received only VAD with no maintenance therapy before 1990 (n=31), and those recruited after 1990 (n=33) were planne d to be maintained with alpha-IFN (5 mU, 3 times per wk) during the pl ateau to a maximum of 2 yr. Median follow-up duration (44 vs. 39 month s), time to response (3.4 vs. 3.5 months) and rate of objective respon se (61.3%, 19/31 and 63.6%, 21/33) were similar in VAD-only and VAD+IF N groups, respectively The survival analyses revealed higher median pr ogression-free (39.6 vs. 12 months) and overall survival (65+ w. 24 mo nths) durations in VAD+IFN group compared Co VAD-only group. VAD regim en was well tolerated and IFN-related side effects were reversible. Th ese findings denote that IFN maintenance prolongs the duration of resp onse obtained by VAD.