Prognostic factors in multiple myeloma treated with prednisolone and sequential melphalan and ifosfamide: MIP combination chemotherapy.

Response rates and survival times were studied in 47 patients who had multiple myeloma and who were being treated with Prednisolone and sequential Melphalan and Ifosfamide (MIP therapy). The clinical response was determined by objective parameters such as the reduction of M-protein level, tumor volume and healing of bone destruction. Twenty-eight of the patients (59.6%) responded to the MIP therapy. The 50% survival time as followed from the initiation of treatment to death was 19 months. Of the prognostic factors, the age (greater than or equal to 70 years), clinical stage III of Durie and Salmon, hypercalcemia, extensive bone lesions, and the patho-morphological type IV of Brücher were associated with a decreased life-span. Therefore, MIP therapy was more effective in poor risk (high tumor mass group) than in good risk (low or intermediate tumor mass group) patients, but the survival of patients on MIP therapy was shorter in the poor risk group than in the good risk one. In addition, the group which responded rapidly (i.e. within 2-5 weeks) had longer remission and longer survival than the group which improved slowly (i.e. after 6-16 weeks).