Differentiated treatment of myeloma. A non-randomised phase two study.

Seventeen consecutive, well stratified stage II and III myeloma patients were given differentiated, combination chemotherapy (cyclophosphamide, vincristine, daunorubicin, etoposide, teniposide, lomustine (CCNU), procarbazine, cytosine arabinoside, and prednisolone), which was more intensive in advanced stages and changed as soon as the patients became refractory. A comparison was made to a previous series of 17 consecutive patients treated with a simple regime of melphalan-prednisolone. Within the first 15 months only one patient in the study group given differentiated treatment died in contrast to 6 patients in the melphalan control group. The median survival times after diagnosis were 45 and 29 months, the 3-year survival 58 and 43%, respectively, and the survival for the first 15 months significantly (p less than 0,05) better in the group given differentiated treatment. The significant difference remained, when comparable patient groups were selected.