Addition of cisplatin and bleomycin to vincristine-carmustine-doxorubicin-prednisone (VBAP) combination in the treatment of relapsing or resistant multiple myeloma: a Southwest Oncology Group study.

Fifty-five patients with myeloma who had relapsed on or were resistant to melphalan and/or cyclophosphamide with prednisone received vincristine, carmustine, doxorubicin, and prednisone (VBAP) plus cisplatin and bleomycin at 21-day intervals. Eighteen (32.7%) patients responded. The response rate was 38.5% (15 responses among 39 patients) in relapsing patients. Three (18.8%) of 16 patients with resistant myeloma responded. Granulocytopenia was the most frequent toxic effect, and was severe in 12 (22%) patients. Severe thrombocytopenia occurred in seven (13%) patients and severe nausea and vomiting occurred in eight (15%). One patient with previously normal renal function developed renal failure on this regimen. The median survival (100 weeks) in those patients responding to treatment was significantly longer than that in patients not responding (25 weeks; P = 0.001). VBAP plus cisplatin and bleomycin was at least as effective as VBAP but had greater toxicity, expense, and inconvenience; it therefore is not preferable to VBAP.