Timed‐sequential high‐dose cyclophosphamide and vincristine in the treatment of multiple myeloma

Abstract

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 M2 as a single‐day dose and VCR 1.4 mg per M2 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. Copyright © 1994 American Cancer Society