Multiple myeloma - historical
The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. As a general rule, this includes the inferior arm(s) of a randomized study, unless said regimens continue to be recommended by trustworthy sources such as the NCCN Guidelines. Please go to the multiple myeloma regimen page to find other regimens.
49 regimens on this page
88 variants on this page
|
Untreated
C-VAMP
| back to top |
C-VAMP: Cyclophosphamide, Vincristine, Adriamycin (Doxorubicin), MethylPrednisolone
Regimen
| Study | Evidence | Comparator |
| Raje et al. 1997 | Phase III | VAMP |
- Cyclophosphamide (Cytoxan)
- Vincristine (Oncovin)
- Doxorubicin (Adriamycin)
- Methylprednisolone (Solumedrol)
References
- Raje N, Powles R, Kulkarni S, Milan S, Middleton G, Singhal S, Mehta J, Millar B, Viner C, Raymond J, Treleaven J, Cunningham D, Gore M. A comparison of vincristine and doxorubicin infusional chemotherapy with methylprednisolone (VAMP) with the addition of weekly cyclophosphamide (C-VAMP) as induction treatment followed by autografting in previously untreated myeloma. Br J Haematol. 1997 Apr;97(1):153-60. link to original article PubMed
VAMP
| back to top |
VAMP: Vincristine, Adriamycin (Doxorubicin), MethylPrednisolone
Regimen
| Study | Evidence | Comparator |
| Raje et al. 1997 | Phase III | C-VAMP |
References
- Raje N, Powles R, Kulkarni S, Milan S, Middleton G, Singhal S, Mehta J, Millar B, Viner C, Raymond J, Treleaven J, Cunningham D, Gore M. A comparison of vincristine and doxorubicin infusional chemotherapy with methylprednisolone (VAMP) with the addition of weekly cyclophosphamide (C-VAMP) as induction treatment followed by autografting in previously untreated myeloma. Br J Haematol. 1997 Apr;97(1):153-60. link to original article PubMed
Consolidation after upfront therapy
Melphalan + TBI -> autologous hematopoietic cell transplant
| back to top |
Regimen
| Study | Evidence | Comparator | Efficacy |
| Attal et al. 1996 | Phase III | VMCP/BVAP x 18 | Seems to have superior OS |
| Moreau et al. 2002 (IFM 9502) | Phase III | High-dose melphalan & autologous transplant | Might have inferior OS |
Treatment in Attal et al. 1996 was preceded by 4 to 6 alternating cycles of VMCP and BVAP. Treatment in IFM 9502 was preceded by VAD x 3.
- Melphalan (Alkeran) 140 mg/m2 IV (day not specified)
- Total-body irradiation in 2 Gy fractions once per day x 4 = total dose of 8 Gy, without lung shielding
One course; relative date of stem cell re-infusion not specified
Followed by interferon alfa maintenance.
References
- Attal M, Harousseau JL, Stoppa AM, Sotto JJ, Fuzibet JG, Rossi JF, Casassus P, Maisonneuve H, Facon T, Ifrah N, Payen C, Bataille R. A prospective, randomized trial of autologous bone marrow transplantation and chemotherapy in multiple myeloma. Intergroupe Français du Myélome. N Engl J Med. 1996 Jul 11;335(2):91-7. link to original article contains verified protocol PubMed
- Moreau P, Facon T, Attal M, Hulin C, Michallet M, Maloisel F, Sotto JJ, Guilhot F, Marit G, Doyen C, Jaubert J, Fuzibet JG, François S, Benboubker L, Monconduit M, Voillat L, Macro M, Berthou C, Dorvaux V, Pignon B, Rio B, Matthes T, Casassus P, Caillot D, Najman N, Grosbois B, Bataille R, Harousseau JL; Intergroupe Francophone du Myélome. Comparison of 200 mg/m(2) melphalan and 8 Gy total body irradiation plus 140 mg/m(2) melphalan as conditioning regimens for peripheral blood stem cell transplantation in patients with newly diagnosed multiple myeloma: final analysis of the Intergroupe Francophone du Myélome 9502 randomized trial. Blood. 2002 Feb 1;99(3):731-5. link to original article PubMed