Toward a cure for multiple myeloma?

THERE has been little progress in the treatment of multiple myeloma since the introduction of the melphalan—prednisone regimen about 25 years ago (for review, see Barlogie et al.¹). The lack of benefit from the addition of alkylating agents and anthracyclines has been well documented in multidrug trials and probably reflects the low level of activity of the individual drugs involved.² Such regimens are designed to minimize myelosuppression, because of the immunodeficiency caused by the disease in what are typically elderly patients. Unfortunately, the marked efficacy of the VAD (vincristine—doxorubicin [Adriamycin] —dexamethasone) regimen in melphalan-resistant myeloma did not translate into.