Korean J Hematol 1996; 31(1):
Published online March 31, 1996
© The Korean Society of Hematology
이종태, 김인호, 안진석, 이기형, 김태유, 박영이, 김효수, 허대석, 방영주
서울대학교 의과대학 내과학교실
Background : Multiple myeloma(MM) remains as an incurable malignant disorder as a
result of resistance to chemotherapy. With standard dose of alkylating agents such as
melphalan and prednisone (MP) or alkylating agent combinations with or without
doxorubicin, responses are achieved in approximately 50% of patients, and relapse
typically ensues after a median of 18 months. Therefore, salvage therapy becomes
important for half of the patients with newly diagnosed MM who fail to achieve
remission(primary refractory) and for responders who have a relapse despite
myelosuppressive doses of chemotherapy(secondary refractory). The VAD regimen,
comprising vincristine and doxorubicin given by continuous infusion along with high
doses of dexamethasone has achieved a marked tumor reduction in about one half of
patients. So we investigated the efficacy of VAD regimen for patients with refractory
multiple myeloma.
Methods: Twenty-two patients with refractory multiple myeloma were treated
according to the VAD protocols proposed by Barlogie et al.
Results: Of the 21 evaluable patients who completed at least one course of therapy, 9
had a complete response(43%). The response rates were 23% for primary refractory
disease patients and 75% for those with secondary refractory disease(P<0.05). The
median duration of response was 3 months(2∼18months) and the median survival for all
22 patients was 5 months(2∼21months+). Peripheral neuropathy was documented in 10
patients(45%). Bacterial infection was observed in 4 patients(1 spontaneous bacterial
peritonitis, 1 pneumonia, 1 sepsis, 1 bacteremia), of whom 2 patients died. Three patients
had mild Herpes zoster infection. Leukopenia and thrombocytopenia were observed in 8
and 2 patients, respectively.
Conclusion : These findings indicate that VAD regimen is effective for the refractory
multiple myeloma, especially for the secondary refractory multiple myeloma, but the
treatment related toxicities were serious.
Keywords Multiple myeloma, VAD chemotherapy, Vincristine, Doxorubicin, Dexamethasone
Korean J Hematol 1996; 31(1): 145-153
Published online March 31, 1996
Copyright © The Korean Society of Hematology.
이종태, 김인호, 안진석, 이기형, 김태유, 박영이, 김효수, 허대석, 방영주
서울대학교 의과대학 내과학교실
Jong Tae Lee, In Ho Kim, Jin Seok Ahn, Ki Hyeong Lee, Tae Yu Kim, Young I Park, Hyo Soo Kim, Dae Seog Heo, Yung, Jue Bang, Seonyang Park, Byoung Kook Kim, Noe Kyeong Kim
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
Background : Multiple myeloma(MM) remains as an incurable malignant disorder as a
result of resistance to chemotherapy. With standard dose of alkylating agents such as
melphalan and prednisone (MP) or alkylating agent combinations with or without
doxorubicin, responses are achieved in approximately 50% of patients, and relapse
typically ensues after a median of 18 months. Therefore, salvage therapy becomes
important for half of the patients with newly diagnosed MM who fail to achieve
remission(primary refractory) and for responders who have a relapse despite
myelosuppressive doses of chemotherapy(secondary refractory). The VAD regimen,
comprising vincristine and doxorubicin given by continuous infusion along with high
doses of dexamethasone has achieved a marked tumor reduction in about one half of
patients. So we investigated the efficacy of VAD regimen for patients with refractory
multiple myeloma.
Methods: Twenty-two patients with refractory multiple myeloma were treated
according to the VAD protocols proposed by Barlogie et al.
Results: Of the 21 evaluable patients who completed at least one course of therapy, 9
had a complete response(43%). The response rates were 23% for primary refractory
disease patients and 75% for those with secondary refractory disease(P<0.05). The
median duration of response was 3 months(2∼18months) and the median survival for all
22 patients was 5 months(2∼21months+). Peripheral neuropathy was documented in 10
patients(45%). Bacterial infection was observed in 4 patients(1 spontaneous bacterial
peritonitis, 1 pneumonia, 1 sepsis, 1 bacteremia), of whom 2 patients died. Three patients
had mild Herpes zoster infection. Leukopenia and thrombocytopenia were observed in 8
and 2 patients, respectively.
Conclusion : These findings indicate that VAD regimen is effective for the refractory
multiple myeloma, especially for the secondary refractory multiple myeloma, but the
treatment related toxicities were serious.
Keywords: Multiple myeloma, VAD chemotherapy, Vincristine, Doxorubicin, Dexamethasone
Sung-Hoon Jung, Youngil Koh, Min Kyoung Kim, Jin Seok Kim, Joon Ho Moon, Chang-Ki Min, Dok Hyun Yoon, Sung-Soo Yoon, Je-Jung Lee, Chae Moon Hong, Ka-Won Kang, Jihyun Kwon, Kyoung Ha Kim, Dae Sik Kim, Sung Yong Kim, Sung-Hyun Kim, Yu Ri Kim, Young Rok Do, Yeung-Chul Mun, Sung-Soo Park, Young Hoon Park, Ho Jin Shin, Hyeon-Seok Eom, Sang Eun Yoon, Sang Mee Hwang, Won Sik Lee, Myung-won Lee, Jun Ho Yi, Ji Yun Lee, Ji Hyun Lee, Ho Sup Lee, Sung-Nam Lim, Jihyang Lim, Ho-Young Yhim, Yoon Hwan Chang, Jae-Cheol Jo, Jinhyun Cho, Hyungwoo Cho, Yoon Seok Choi, Hee jeong Cho, Ari Ahn, Jong Han Choi, Hyun Jung Kim and Kihyun Kim
Blood Res 2025; 60():Haerim Chung, Hyunsoo Cho
Blood Res 2023; 58(4): 166-172Ja Min Byun, Sung-Soo Park, Sung-Soo Yoon, Ari Ahn, Myungshin Kim, Jung Yeon Lee, Young-Woo Jeon, Seung-Hwan Shin, Seung-Ah Yahng, Youngil Koh, Chang-Ki Min
Blood Res 2023; 58(2): 83-90