[Effect of various chemotherapy regimens on survival and cause of death in patients with multiple myeloma (retrospective study)].

A retrospective analysis of survival time and causes of death has been undertaken in 109 patients treated for multiple myeloma (MM) at the Hematologic Clinic of the Russian Research Institute of Hematology and Transfusiology in 1979-1995. Group I included cases of mono- and group II-polychemotherapy (PCT). Survival in patients with MM increased significantly (from 27 to 43 months) after PCT. The main causes of death in MM patients of group I were chronic renal failure and infectious complications, while in group II-intoxication syndrome including blood toxicity, toxic hepatitis, etc. In cases of this grave disease, the effectiveness of therapy appeared to depend on both main and supporting treatment. Of great importance was profuse hydration using diuretics, active rheologic preparations, plasmapheresis and other counter-complication means. Following the administration of immunity correction drugs (thymaline, tactivin, immunoglobulin), infectious complication incidence in group II dropped from 22 to 8.3%. It is suggested that the effectiveness of MM therapy is determined by stage-by-stage approach, course cycling of PCT and adequate evaluation of its criteria. PCT courses should be supplemented with infusion detoxication measures, particularly, in cases of highly aggressive PCT schemes, and procedures of immunity correction, hemo-component therapy and plasmapheresis.