A group of 48 patients with myeloma was given intermittent courses of melphalan, 0.15 mg/kg/day for seven days. Subjective improvement was noted in 50% (24) of patients, objective improvement in 65% (31). Forty percent (19) of the patients had a response as drafted in this study. Of patients who were studied more than three months, the responding patients lived significantly longer than the nonresponding patients. A higher objective response rate was found in the patients who were treated until there was significant thrombocytopenia. Two consecutive studies indicate that continuous maintenance therapy with melphalan is probably better than intermittent maintenance for control of pain. There is accumulative evidence that melphalan prolongs life in patients with multiple myeloma.
Hoogstraten B, Costa J, Cuttner J, et al. Intermittent Melphalan Therapy in Multiple Myeloma. JAMA. 1969;209(2):251–253. doi:10.1001/jama.1969.03160150037009
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