Cyclophosphamide vs Melphalan in Treatment of Plasma Cell Myeloma

The Veterans Administration Cancer Chemotherapy Group and the Pacific Veterans Administration Chemotherapy Group compared daily orally administered doses of cyclophosphamide and melphalan in the treatment of plasma cell myeloma, in a randomized double-blind study. Of the 150 patient studies, 33 were inadequate trials and 14 patients were removed. There were no complete remissions. Of the 50 adequate trials with cyclophosphamide there were nine partial remissions and 19 questionable responses. Of the 53 adequate trials with melphalan there were eight partial remissions and 13 questionable responses. Toxicity was similar except for more thrombocytopenia in the melphalan treated group. The median survival was 12.3 months in the group receiving cyclophosphamide and 15.5 months in the patients receiving melphalan, a statistically insignificant difference. Both drugs appear to be equally effective in the treatment of myeloma.