Interferon-alpha-2b with VMCP for induction in multiple myeloma: The israel myeloma cooperative group experience

A. M. Cohen, D. Meytes, A. Many, B. Brenner, E. Aghai, M. Shaklai, S. Kaufman, M. Shtalrid, D. Attias, Y. Manor, Y. Kahan, H. Farbstein, A. Polliack

Research output: Contribution to journalArticlepeer-review

Abstract

In 1988, a prospective, randomized multicenter study was initiated to determine the efficacy of a combined induction regimen with recombinant interferon-alpha-2b (IFN-α) and maintenance with IFN-α on the response and survival rates in multiple myeloma (MM) patients. Induction therapy consisted of VMCP (vincristine, melphalan, cyclophosphamide, prednisone), randomized to combine IFN-α at a dose of 2 x 106 U, 5 days per week throughout the induction period of 12 months. Patients who achieved plateau phase were subsequently randomized again between IFN-α maintenance (2 x 106 U, 3 days a week) for 12 months and no maintenance therapy. Of the previously untreated patients, 84 were initially randomized for induction therapy, and 31 for the maintenance phase with IFN-α. Results of the cohort median survival, based on the intention to treat, have shown that those on the VMCP/IFN-α arm had a median survival of 53 months, compared with patients on the VMCP induction arm who had a median survival of 26 months (P = 0.052). The median survival of stage 3 evaluable patients who were on the VMCP/IFN induction arm was 43 months, and 13 months for patients treated by VMCP alone (P = 0.008). No significant difference in survival was detected among patients in partial remission (after induction) who had a second IFN-α randomization at the plateau phase. Hematologic toxicity, mild to moderate fever, and fatigue were more common in the VMCP/IFN induction arm. The results show that VMCP/IFN is a well-tolerated treatment regimen, and is superior to VMCP for patients with stage 3 myeloma.

Original languageEnglish
Pages (from-to)604-610
Number of pages7
JournalIsrael Journal of Medical Sciences
Volume31
Issue number10
StatePublished - 1995
Externally publishedYes

Keywords

  • Chemotherapy
  • Immune modifiers
  • Interferon-alpha
  • Multiple myeloma

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