Cohen H J, Bartolucci A A, Forman W B, Silberman H R
J Clin Oncol. 1986 Jun;4(6):888-99. doi: 10.1200/JCO.1986.4.6.888.
A randomized, controlled trial was initiated in 1977 to evaluate the impact of three alternative approaches to consolidation and maintenance therapy after initial maximal response for multiple myeloma. All patients were treated initially with BCNU, cyclophosphamide, and prednisone (BCP) until a designated level of response was achieved. Responders were randomly assigned to either melphalan and prednisone (MP); prednisone, Adriamycin (Adria Laboratories, Columbus, Ohio), azathioprine, and vincristine (PAIV), or no therapy until relapse, then treatment with BCP. Initial response rates were comparable with previous trials. A small number of incremental responses were observed with both MP and PAIV. Survival was the same for all three maintenance approaches and the same as that observed in our previous continuous BCP or MP therapy. Additional or consolidation/maintenance therapy of the type administered here appears to offer little advantage once an initial response has been achieved.
1977年开展了一项随机对照试验，以评估针对多发性骨髓瘤在初始达到最大反应后进行三种巩固和维持治疗替代方法的影响。所有患者最初均接受卡莫司汀、环磷酰胺和泼尼松（BCP）治疗，直至达到指定的反应水平。反应者被随机分配至美法仑和泼尼松（MP）组；泼尼松、阿霉素（阿德里亚实验室，俄亥俄州哥伦布市）、硫唑嘌呤和长春新碱（PAIV）组，或直至复发不进行治疗，然后用BCP治疗。初始反应率与之前的试验相当。MP组和PAIV组均观察到少量的递增反应。三种维持治疗方法的生存率相同，且与我们之前连续使用BCP或MP治疗时观察到的生存率相同。一旦获得初始反应，此处所给予的此类额外或巩固/维持治疗似乎几乎没有优势。
