melphalan and pafencil

Overall 30 patients with multiple myeloma (MM) were examined for immunological and rheological parameters. MM was shown to be marked by imbalance of immunobiological reactivity, with the greatest changes being seen in the B cell immunity system. MM is also characterized by marked rheological shifts related to the immunological alterations and underlying the hyperviscosity syndrome and heart failure. Administration of polychemotherapy resulted in a decrease of the count of B lymphocytes, circulating immune complexes; a tendency toward normalization of the rheological blood properties was observed. Introduction of plasmapheresis into the treatment program of the patients noticeably raised the treatment efficacy.

Topics: Adult; Aged; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Blood Viscosity; Chronic Disease; Cyclophosphamide; Daunorubicin; Female; Heart Failure; Humans; Immunity, Cellular; Kidney Failure, Chronic; Male; Melphalan; Middle Aged; Multiple Myeloma; Nitrogen Mustard Compounds; Prednisolone; Vincristine

Three different programs of polychemotherapy (PCT) of multiple myeloma (MM) were compared. The programs included the use of cyclophosphamide (up to 750 mg/m2), vincristine (1.4 mg/m2), rubomycin (40 mg/m2), sarcolysine (7.5 mg/m2), paphencyl (50 mg/day) and prednisolone (from 30 to 60 mg/m2) in different combinations with regard to the hemocoagulation and rheological blood properties. It has been shown that in patients with MM there occur profound hemocoagulation and rheological alterations playing an important part in the genesis of the syndrome of hyperviscosity and circulation failure. The use of the programs of PCT in conjunction with therapeutic plasmapheresis brought about an appreciable improvement of the patients' general health status and correction of hemocoagulation and hemorheological disorders. To control the efficacy of PCT, its individualization, intensity and duration, it is recommended that in addition to the common tests, the activity of the antithrombin-III-heparin complex may be measured and the test for the presence of fibrin monomer in the plasma be made, since these parameters clearly reflect the changes in the system of hemostasis and enable one to discover the early signs of proliferation activation in MM thereby preventing hemorrhages.

Topics: Adult; Aged; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Blood Coagulation; Blood Viscosity; Chronic Disease; Cyclophosphamide; Daunorubicin; Drug Evaluation; Female; Humans; Male; Melphalan; Middle Aged; Multiple Myeloma; Nitrogen Mustard Compounds; Prednisolone; Vincristine