It would be wrong to specify a specific age cutoff for transplantation. We all know patients who are 50 years old and look like they are 75. Conversely, we all know patients who are in their late 60's and look like they are in their early 50's. It is this biologic age which we believe is far more important than chronologic age, and this must be taken into account when counseling the pros and cons of the various treatments available for multiple myeloma. Melphalan is a class of drugs called alkylating agents.
Prednisone is a cortisone drug.
Cortisone is frequently used to treat certain forms of arthritis, and its anti-inflammatory properties are frequently used in the treatment of certain neurological disorders and disorders of immunity. The cells of multiple myeloma appear to have on their surface binding sites for cortisone and cortisone derivatives, and cortisone medications such as prednisone are actually capable of killing myeloma cells. The use of melphalan and prednisone was popularized in this country by Dr. Raymond Alexanian, a contributor to this newsletter and a well-regarded authority in this field. Melphalan and prednisone are both oral agents that are usually given for four days every month or for seven days every six weeks. Both regimens are effective, and one is not preferred over the other but rather is chosen for patient convenience.