多発性骨髄腫における化学療法の治療効果と骨病変に関する臨床的検討　第1編 多発性骨髄腫における Aclarubicin, Vincristine, Cyclophospamide, Prednisolone 併用療法における治療効果と予後因子に関する臨床的検討

Sixty-one patients with multiple myeloma consisting of 45 previously untreated and 16 previously treated patinets were given combination therapy of aclarubicin, vincristine, cydlo-phosphmide and prednisolone. The overall response rate evaluated by 50% reduction in M-protein was 47%. The median survival time 40 months, which indicated satisfactory effectiveness. The previously untreated patients with stage Ⅲ disease had a much higher response rate (58%) than those with stage Ⅱ (33%). There was no significant difference in the 5-year survival between the patients with stage Ⅲ (33%) and stage Ⅱ (33%) disease. These findings indicate the effectiveness of the therapy for stage Ⅲ cases, especially patients with stage Ⅲ disease under good control showed long-term survival of more than 5 years. Marked symptomatic inpovement was observed in 77%. For patients with advanced bone lesion the therapy was also valuable. The multivariate anaysis (proportional hazard model of Cox) of individual biochemical and clinical variables showed that the tumor was the most significant variable related to prognos-tic factor followed by good and poor control and serum calcium level. Hematologic toxicity, infection, nausea and vomiting occurred frequently, although the incidence of ECG change (9%) was low and transient.

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