Multiple myeloma remains incurable as well as the other low-grade limphoproliferative diseases. Asymptomatic early stage patients don´t require chemotherapy. The asymptomatic early stage may last for several years with spontaneous remissions. An untimely chemotherapy wouldn´t be life-extending and could even harm the asymptomatic patients putting him at risk of secondery myelodisplastic syndrome. Thus, the chemotherapy in multiple myeloma (as well as in others low-grade limphoproliferative diseases) is instituted only at the time of disease progression when the mclassancy starts to manifest with clinical symptoms.
The patients older than 65 (70) years of age and patients contraindicated for high-dose chemotherapy with stem cell transplantation are treated with conventional chemotherapy. The patients receive the chemotherapy for 7 - 9 months or, according to another system, till the maximal reduction of immunoglobulin level is achieved or till the remission is achieved.
Polychemotherapeutical treatment regimes enable quick medical response that benefits the patients with pains or other severe symptoms, providing them a better quality of life. Polychemotherapeutical approaches lead to medical response in aggresive forms of multiple myeloma in which melphalan with prednisone has a limited and delayed effect.
Oral chemotherapy with melphalan-prednisone is the standard treatment for elderly patients with less aggressive forms of multiple myeloma having a relatively later effect.
