Forgeson G V, Selby P, Lakhani S, Zulian G, Viner C, Maitland J, McElwain T J
Institute of Cancer Research, Royal Marsden Hospital, Surrey, UK.
Br J Cancer. 1988 Oct;58(4):469-73. doi: 10.1038/bjc.1988.243.
Forty-five patients with relapsed or refractory multiple myeloma received continuous infusions of vincristine (0.4 mg total dose daily for 4 days) and adriamycin (9 mg m-2 daily for 4 days) with a high dose of methylprednisolone (1 g m-2 i.v. or p.o. daily by 1 h infusion), the VAMP regimen. Sixteen (36%) responded, with a median duration of remission of 11 months and median survival of 20 months. Major toxicities encountered were infective and cardiovascular. Two smaller groups of myeloma patients were treated with high dose methylprednisolone (HDMP) alone, or VAMP plus weekly low dose cyclophosphamide (Cyclo-VAMP). HDMP produced short responses in 25% of patients with less toxicity than VAMP. Cyclo-VAMP was used in a highly selected group of patients who had previously responded to high dose melphalan. It was well tolerated and produced responses in 61% of this group.
45例复发或难治性多发性骨髓瘤患者接受长春新碱（总剂量0.4mg/日，共4天）和阿霉素（9mg/m²/日，共4天）持续输注，并联合大剂量甲泼尼龙（1g/m²，静脉注射或口服，每日1小时输注），即VAMP方案。16例（36%）患者出现缓解，缓解期中位数为11个月，中位生存期为20个月。主要毒性反应为感染性和心血管性。另外两组较小的骨髓瘤患者分别接受单纯大剂量甲泼尼龙（HDMP）治疗，或VAMP联合每周小剂量环磷酰胺（Cyclo-VAMP）治疗。HDMP使25%的患者产生短期缓解，毒性低于VAMP。Cyclo-VAMP用于一组经过高度选择、先前对大剂量美法仑有反应的患者。该方案耐受性良好，该组61%的患者出现缓解。
