Report on the second myelomatosis trial after five years of follow-up. Medical Research Council's Working Party on Leukaemia in Adults.
Three hundred and seventy-two patients were randomized between 3 regimens of chemotherapy: cyclophosphamide, intermittent melphalan, and melphalan with prednisone, and were followed up to death or for at least 5 years. There was no difference in survival between the treatments, either overall or in any subgroup of patients. Therefore, the choice among these 3 treatments should be guided by the patient's comfort and convenience. The most important prognostic feature at presentation was the quality of renal function. It was possible to define good, intermediate and poor renal-function groups which were highly correlated with prognosis (X2 for trend = 62.6). The haemoglobin level at presentation was strongly correlated with prognosis among patients in the good renal-function group. Among 107 patients who presented with good renal function and with haemoglobin above 100 g/l, the 5-year survival was 43%. Other prognostic features were much less important when account was taken of renal function and haemoglobin level.