TIMED-SEQUENTIAL HIGH-DOSE CYCLOPHOSPHAMIDE AND VINCRISTINE IN THE TREATMENT OF MULTIPLE-MYELOMA

Background. This study was designed to examine the efficacy and toxicity of high-dose cyclophosphamide (CY), and to evaluate the potential added effect of vincristine (VCR) given at a theoretic time of malignant cell stimulation in a group of patients with multiple myeloma, refractory to or relapsing after, treatment with standard doses of chemotherapy. Methods. Patients were randomly assigned to receive CY 2400 mg per M(2) as a single-day dose and VCR 1.4 mg per M(2) given on Day 1 or Day 9 after the CY. Results. There were 108 cases suitable for analysis. No difference in objective response (17.6%, 23.5%), subjective response, remission duration, or survival was observed in the two treatment arms. Conclusions. The authors conclude that a single, high dose of cyclophosphamide is more toxic and provides equal or less response than the equivalent dose given over 4 consecutive days and that no improved effect was detected using timed-sequential therapy with VCR.