Alexanian R, Gehan E, Haut A, Saiki J, Weick J
Blood. 1978 Jun;51(6):1005-11.
Twenty-eight patients with multiple myeloma responding to prior melphalan-prednisone combinations, but without additional chemotherapy, were followed until relapse. Patients receiving no further treatment had a median survival time similar to that of those receiving indefinite courses of melphalan-prednisone or carmustine-prednisone. Prolonged periods of unmaintained remission occurred primarily in patients without extensive disease at the time of diagnosis or in whom the abnormal protein disappeared from the electrophoresis strip. The initial relapse after an unmaintained remission was controlled in 80% of patients with the resumption of melphalan-prednisone, but second remissions were usually less marked in degree and shorter in duration. Results supported the long-term evaluation without chemotherapy of selected patients with low numbers of plasma cells after treatment who were likely to experience long durations of disease stability and respond again to retreatment with melphalan-prednisone.
28例曾对美法仑-泼尼松联合治疗有反应但未接受其他化疗的多发性骨髓瘤患者，随访至复发。未接受进一步治疗的患者中位生存时间与接受美法仑-泼尼松或卡莫司汀-泼尼松不定疗程治疗的患者相似。长期未维持缓解主要发生在诊断时无广泛病变或异常蛋白从电泳条带消失的患者中。80%未维持缓解后首次复发的患者通过重新使用美法仑-泼尼松得到控制，但第二次缓解通常程度较轻且持续时间较短。结果支持对治疗后浆细胞数量少、可能经历长期疾病稳定且对美法仑-泼尼松再治疗有反应的特定患者进行无化疗的长期评估。
