A review of current treatment options in @entity1582 is presented, including data on health-related quality of life and pharmacoeconomics. For induction chemotherapy, no combination of cytostatic drugs has been shown to be consistently superior to the simple cyclic oral treatment with melphalan and @entity229 that has been available for 30 years. The total resource consumption and direct costs per @entity1 treated with @entity3601 and @entity229 is approximately  US10,000 (1995 values). As median survival is prolonged from less than a year in untreated @entity1 to 30 to 36 months, this treatment must be considered cost effective. Interferon-alpha has a modest effect on progression-free and overall survival when added to chemotherapy regimens. However, the high cost and @entity137 of this drug results in an unfavourable cost-utility ratio, estimated to be between  US50,000 to  US100,000 per quality-adjusted life-year gained. Clinical trials suggest that high dose chemotherapy followed by autologous stem cell support administered to @entity1 who have achieved disease stabilisation or objective response to conventional induction chemotherapy, prolongs median survival by about 1.5 years. Preliminary cost-utility analyses suggest a cost per life-year gained of  US30,000 to  US40,000. Further potential improvements of this therapeutic modality are under way. Several @entity171 have been tested for the ability to prevent the skeletal complications of @entity1582 . Monthly infusions of @entity5279 have been shown in 1 randomised trial to significantly reduce the rate of skeletal complications. Unfortunately, the rapid and widespread acceptance of this therapy seems to preclude further prospective, placebo-controlled trials with cost-utility evaluation.

Therapeutic options in the treatment of XXXX : pharmacoeconomic and quality-of-life considerations.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity137 :: ('MESH:D064420', 'Disease') :: ['toxicity'] @entity171 :: ('MESH:D004164', 'Chemical') :: ['bisphosphonates'] @entity5279 :: ('MESH:C019248', 'Chemical') :: ['pamidronate'] @entity229 :: ('MESH:D011241', 'Chemical') :: ['prednisone'] @entity3601 :: ('MESH:D008558', 'Chemical') :: ['melphalan'] @entity1582 :: ('MESH:D009101', 'Disease') :: ['multiple myeloma']
@entity1582 :: (MESH:D009101,Disease) :: ['multiple myeloma']
