Primary dexamethasone treatment of multiple myeloma

Blood. 1992 Aug 15;80(4):887-90.


Intermittent courses of dexamethasone (DEX) were administered to 112 consecutive, previously untreated patients with multiple myeloma (MM). Using criteria based on a 75% or greater reduction of calculated tumor mass, the overall response rate was 43%. Among comparable patients, response rate were approximately 15% less than those observed previously with vincristine-doxorubicin by continuous infusion with intermittent DEX (VAD) and similar to those with melphalan-prednisone. The projected survival times with VAD or DEX were similar. Results indicated that DEX accounted for most of the plasma cell reduction achieved with VAD. Serious complications occurred in 27% of patients treated with VAD, but in only 4% of those who received DEX. In view of the similar outcome with fewer serious complications, DEX provided a simple, effective, and safe primary treatment for a large fraction of patients with MM. Patients who appear most likely to benefit include those with hypercalcemia or pancytopenia, or who require simultaneous radiotherapy for a pathologic fracture.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Dexamethasone / administration & dosage
  • Dexamethasone / adverse effects
  • Dexamethasone / therapeutic use*
  • Doxorubicin / administration & dosage
  • Doxorubicin / therapeutic use
  • Humans
  • Melphalan / administration & dosage
  • Melphalan / therapeutic use
  • Middle Aged
  • Multiple Myeloma / drug therapy*
  • Prednisone / administration & dosage
  • Prednisone / therapeutic use
  • Remission Induction
  • Vincristine / administration & dosage
  • Vincristine / therapeutic use


  • Vincristine
  • Dexamethasone
  • Doxorubicin
  • Melphalan
  • Prednisone