Long‐term follow‐up and therapy in multiple myeloma

Abstract

The clinical manifestations and laboratory features of 38 patients with multiple myeloma seen over a 4‐year period at a 200‐bed university hospital are presented in detail. Treatment consisted of melphalan in standard 7‐ to 10‐day initial courses followed by maintenance with the same drug. The criteria used in the subjective and objective evaluation of these patients, as well as the hematologic effects of melphalan, are reviewed. Analysis of the survival data in these patients, as compared to a similar group of myeloma patients not treated with melphalan, revealed a statistically significant difference (p < 0.01) in survival between the 2 groups, especially when referring to different time intervals after the onset of therapy. It is concluded that melphalan is the chemotherapeutic agent of choice which together with other alkylating agents such as cyclophosphamide remain as the most desirable chemotherapeutic agents in this disease. An assortment of other supportive measures, such as androgens, early ambulation, fluorides, systemic calcium, and a comprehensive rehabilitation program, complete the physician's armamentarium for the more comprehensive management and longer survival of these patients. Copyright © 1971 American Cancer Society