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Assessment of early paraprotein response to vincristine-doxorubicin-dexamethasone chemotherapy may help guide therapy in multiple myeloma

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Vincristine, doxorubicin and dexamethasone (VAD) are commonly used as the initial chemotherapy in myeloma patients prior to high-dose therapy and autologous stem cell transplantation. We reviewed monoclonal protein responses and survival of 62 patients treated in this way. Among patients with IgG paraprotein, achievement of at least 50% reduction in paraprotein after the first cycle of VAD correlated with significantly better event-free survival at 3 years, compared with those having less than 50% response. We postulate that early paraprotein response may be used to identify high risk patients. (Intern Med J 2004; 34: 576−578)

Keywords: autologous ­transplantation; multiple myeloma; paraprotein; prognostic factors

Document Type: Research Article


Affiliations: Division of Haematology, Institute of Medical and Veterinary Science and Department of Clinical Haematology, Royal Adelaide Hospital, Adelaide, South Australia, Australia

Publication date: September 1, 2004

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