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Annals of Oncology 12:105-108, 2001
© 2001 European Society for Medical Oncology

research-article

Cyclophosphamide, adriamycin and dexamethasone (CAD) is a highly effective therapy for patients with advanced multiple myeloma

H. Szelényi1, E. D. Kreuser2, U. Keilholz1, H. D. Menssen1, C. Keitel-Wittig3, J. Siehl1, W. Knauf1 and E. Thiel1

1Universitätsklimkum Benjamin Franklin, Medizimsche Klnik III, Freie Universttät Berlin Berlin
2Krankenhaus der Barnherzigen Brüder Regensburg
3Onkologische Praxis Dr Keilel-Wiltig, Dr Herrenberger Berlin, Germany

Prof Dr U Keilholz Universitätsklinikum Benjamin Franklin Medizinische Klinik III (Hämatologie/Onkologie/Transfusionsmedizin) Hindenburgdamm 30 12200 Berlin Germany E-mail szelenyi{at}zedat.fu-berhn.de

BACKGROUND: Patients with advanced multiple myeloma (stage III or progressive myeloma) received the CAD protocol every three weeks cyclophosphamide 200 mg/m2 l v /orally days 1–4, adriamycin 30 mg/m2 l v on day 1 and dexamethasone 40 mg p o days 1–4

PATIENTS AND METHODS: Forty-six patients with a median age of sixty years (range 34–84 years) were enrolled According to Dune-Salmon 44 patients were in stage III, 2 in stage II, 6 patients had renal insufficiency (stage B) Twenty-three patients were pre-treated at least with melphalane/prednisone.

RESULTS: Remission rates were as follows complete remission 4%, partial remission 70%, minimal change 11%, no change 11%, progressive disease 47% After an observation time of 14 months the median progression free interval for 33 patients not treated with subsequent high-dose chemotherapy with stem-cell support was more than 14 months Overall, treatment was well tolerated After 209 cycles given febrile neutropenia occurred in 11% of cycles including one fatal outcome Neutropenia or thrombocytopenia grade 3–4 WHO was recorded in 18% and 6% of the cycles, respectively

CONCLUSIONS: This study shows that CAD is an effective regimen with an overall remission rate of 74% The CAD protocol should be further evaluated in prospective trials

adriamycin,, chemotherapy,, cyclophosphamide,, dexamethasone,, multiple myeloma


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