Melphalan Therapy for Plasma Cell Myeloma

Of 82 patients with plasma cell myeloma treated with melphalan, 40 (49 per cent) were improved in clinical status and in a direct manifestation of disease. Myeloma protein level provided an important parameter for periodic assessment of disease activity. After effective chemotherapy, myeloma globulins decreased more rapidly and to a greater degree in urine than in serum. Anemia and hypoalbuminemia were improved in most responding patients, thus supporting the usefulness of these parameters in confirming clinical response. Median survival time for all patients was 42 months from symptoms, 34 months from diagnosis, and 23 months from melphalan. The life-span of responding patients was prolonged more than 2 years, a period accounted for by the duration of objective response. Future progress in treatment for plasma cell myeloma will depend more on advances in chemotherapy than upon improvements in supportive care.