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Short course intermediate dose intravenous melphalan therapy in myeloma--relation to early emergence of drug resistance (phase II study).

Intermediate dose intravenous melphalan at a dose of 15 mg/m2 x 4 given at 21-day intervals has been evaluated in 20 consecutive patients. The aims were to assess the time to obtain maximal response, duration of response and response to reintroduction of intravenous melphalan on relapse. Median time to maximal response was 17 weeks. Four patients achieved a complete response with complete disappearance of paraprotein. On relapse, reintroduction of intravenous melphalan was unsuccessful in causing a reduction of paraprotein, suggesting that resistance to this dose of melphalan occurs early even in responding patients.