Myeloma during a decade: Clinical experience in a single centre

One hundred and fifty-six patients with multiple myeloma weretreated over a period of 12 years at St. Bartholomew's Hospital.The progress of the disease was affected in 96/156 patients(61%). Response was defined as achieving a plateau of M component.A partial or complete response was seen in 68/120 patients treatedconventionally (56.5%), and in 28/36 patients treated with high-dosetherapy (77.7%). The median survival of the group as a wholewas 20 months, with a 2-year survival of just over 40%. In the36 patients treated with high-dose therapy, median survivalwas 6 years, and in a small group who have had maintenance Interferontherapy, the median has not yet been reached. In a univariateanalysis, age, intensity of therapy, haemoglobin and creatininelevels were significant, but multivariate analysis showed thatonly age and intensity of therapy were independent predictorsfor survival. The outlook for relapsed patients who showed progressionof disease remains poor, but palliation was best achieved bysteroid and Interferon in combination. Patients who achievecomplete responses and are maintained on Interferon appear tobe doing better both in terms of freedom from symptoms and insurvival, and methods to enable an elderly population to toleratethis form of therapy need to be explored. intensive chemotherapy, maintenance and relapse therapy, myeloma, survival