Melphalan Therapy in Myelomatosis

Abstract

Effect of melphalan in the treatment of myelomatosis was studied in 17 case with this disorder out of 25 cases given melphalan during 4 year period.
Six to 10 mg melphalan per day was administered for 7 days as an initial loading dose, followed by maintenance therapy with 2 mg daily after the pause to get the recovery of leukocyte count. Therapy with intermittent large doses was given in a few cases.
With a criteria for improvement such as decrease in serum M-component or Bence Jones protein excretion in urine less than 50% of the intial values, decrement of diameter of tumor to less than half of the pretreatment size and disappearance of pain, excellent response to melphalan therapy was obtained in 5 cases, and good response in 6 cases, while 6 patients did not respond to melphalan. Pain relief was the most remarkable effect in responsive cases. The 50% survival of responders was 30.0 months in contrast to 16.5 months in non-responders. There was no significant difference found in the rate of response among patients with different classes of Heavy chain or different types of Light chain of abnormal serum or Bence Jones protein.
Melphalan is considered as the first choice drug for myelomatosis if it is administered under careful observation of patient's hematologic status.