Long-term survival in myelomatosis; A REPORT TO THE MRC WORKING PARTY ON LEUKAEMIA IN ADULTS

Abstract

The patients entered into the Medical Research Council''s First Myelomatosis Trial (MRCI) were followed-up for a minimum of 12 yr, and an attempt was made to define features recorded at presentation that could predict long-term survival and to estimate the risk of acute myeloid leukemia (AML) induced by treatment with either of the alkylating agents, melphalan or cyclophosphamide. The chance of a patient surviving 5 years was strongly related to the Hb, blood urea concentration (BUC) and performance status at presentation. Other features, including paraprotein levels, type of H or L chain, bone lesions and recovery of polyclonal Ig added little useful information. Six patients died of AML, all after > 4 yr in the trial; the incidence of AML among 4-yr survivors was 10%. All 6 patients had been treated with continuous melphalan and the implications of this for future chemotherapy for myelomatosis are discussed.