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Combined chemotherapy with ABCM versus melphalan for treatment of myelomatosis
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The Medical Research Council Working Party For Leukæmia In Adults (Including: MacLennan, I. C. M., Chapman, C., Dunn, Janet A. and Kelly, K.). (1992) Combined chemotherapy with ABCM versus melphalan for treatment of myelomatosis. The Lancet, 339 (8787). pp. 200-205. doi:10.1016/0140-6736(92)90004-M ISSN 0140-6736.
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Official URL: https://doi.org/10.1016/0140-6736(92)90004-M
Abstract
Both melphalan and cyclophosphamide increase life expectancy in patients with myelomatosis, but few large randomised studies have compared combination chemotherapy regimens with these single agents. In the Vth MRC myelomatosis trial, the survival of 314 patients randomised to receive ABCM (adriamycin, BCNU, cyclophosphamide, and melphalan) as first-line treatment was significantly longer than that of 316 patients given intermittent melphalan (M7) (p=0·0003). The 75%, median, and 25% survivals were 7, 24, and 42 months, respectively, with M7 and 10, 32, and 56 months, respectively, with ABCM. Stable disease with few symptoms (plateau) was achieved by 61% of patients given ABCM and 49% of those given M7 (p = 0·004). Myelotoxicity was comparable between regimens. Cross-trial analysis suggests that M7 is comparable to melphalan and prednisone or melphalan, prednisone, and vincristine; that the efficacy of ABCM in the Vth trial and Vlth M RC trials is comparable; and that ABCM gave better survival than intermittent melphalan regimens in the prognostic groups analysed. The results indicate that ABCM is an acceptable regimen that is more effective than melphalan, with or without prednisone, for first-line treatment of myelomatosis.
Item Type: | Journal Article | ||||
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Subjects: | R Medicine > R Medicine (General) | ||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | The Lancet | ||||
Publisher: | Lancet Publishing Group | ||||
ISSN: | 0140-6736 | ||||
Official Date: | 25 January 1992 | ||||
Dates: |
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Volume: | 339 | ||||
Number: | 8787 | ||||
Page Range: | pp. 200-205 | ||||
DOI: | 10.1016/0140-6736(92)90004-M | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Restricted or Subscription Access |
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