다발성 골수종에 대한 Vincristine , Melphalan 및 Prednisone ( VMP ) 복합화학요법의 치료 효과

Background: The combination of melphalan and prednisone has been the standard therapy for multiple myeloma. However, owing to the emergence of the drug resistance, essentially most patients have relapse or progrssion during chemotherapy. Vincristine was reported to be albe to prevent the development of the resistance to melphalan. Methods: Sixty two patients with multiple myeloma were treated with a combination chemotherapy of vincristine, melphalan and prednisone (VMF). The regimen consists of vincristine 0.03 mg/kg i.v. (day 1), melphalan 0,1 mg/kg p.o. (day 1-7) and prednisone 1mg/kg p.o. (day 1-7), which was repeated every four weeks. Results: Among 51 evaluable patients, 29 patients (56%) achieved objective responses. The median duration of response was 15 months. The median time to progression of overall patients was 11 months. The factors influencing response were age (p<0.04) and performance status (p<0.03). The overall median surivival was 36 months. The single most important factor associated with prolonged survival was the responsiveness to remission induction chemotherapy (p<0.001). Leukopenia was observed in 42% and thrombocytopenia in 2%. Neurotoxicity due to vincristine was found in 5.2% of the patients. Conclusions: The VMP regimen was associated with relatively high response rate and well tolerted, producing only mild bone marrow suppression and neuratoxicity. This result shows that VMP combination chemotherapy is an effective treatment regimen for multiple myeloma.