Klin Onkol 1998; 11(3): 73-79.
Summary: Multiple myeloma is a disease that responds to chemotherapy in 70 % of cases. However, the response rate in relapse is lower, and the disease gradually escapes from treatment control and kills the patient. Glucocorticoids or combination chemotherapy regimens containing non-cross resistant cytostatic drugs are most frequently used for these patients. Intensive chemotherapy with leucocyte growth-factors or high-dose chemotherapy with autologous, or allogeneic haematopoietic stem cell transplantation are less frequently used in this setting.
High dose chemotherapy with autologous stem cell support have brought significant benefit to patients with chemosensitive relapse but this type of treatment has had only limited success in cases of chemoresistant relapse. Allogeneic transplantation is considered to be beneficial for young patients in relapse with negative prognostic factors. Various modifications of maintenace therapy for patients in second remission are tested. All these treatment possibilities are reviewed in this paper.
