We examined the feasibility of achieving a rapid response in patients with previously untreated multiple myeloma by administering vincristine 0.4 mg and doxorubicin 9 mg/m2 as a rapid intravenous infusion for 4 d together with intermittent high-dose dexamethasone 40 mg (VAD) for remission induction treatment in patients who were scheduled to receive high-dose therapy. 139 patients (86 male, 53 female; median age 53 years, range 32-65 years; Durie & Salmon stage IIA: 42, IIB: one, IIIA: 89, IIIB: seven) were included in a prospective multicentre study in which VAD was administered as remission induction treatment and was followed by intensified treatment. The response was evaluated according to the criteria of the Eastern Cooperative Oncology Group (ECOG). The results of treatment were evaluable in 134 patients. Five patients died before evaluation. 86 patients (62%) achieved a partial response (PR) and seven patients (5%) achieved a complete response (CR), which equates to a response rate of 67%. The main side-effect was mild neurotoxicity, which was observed in 18% of the patients. Fever or infections were reported in 27% of the patients. VAD administered as an outpatient regimen, based on rapid intravenous infusion, is an effective induction regimen for untreated myeloma with a 67% response rate and acceptable toxicity.
Time-Reversal-Invariance non-conservation has for the first time been unequivocally demonstrated in a direct measurement at CPLEAR. One then can ask the question: What about tests of time-reversal-invariance in systems other than the kaon system? Tests of time-reversal-invariance can be distinguished as belonging to two classes: the first one deals with parity violating (P-odd)/time-reversal-invariance-odd (T-odd) interactions, while the second one deals with P-even/T-odd interactions (assuming CPT conservation this implies C-conjugation non-conservation). Limits on a P-odd/T-odd interaction follow from measurements of the electric dipole moment of the neutron (with a present upper limit of 8 × 10 −26 e.cm [95% C.L.]). It provides a limit on a P-odd/T-odd pion-nucleon coupling constant which is less than 10 −4 times the weak interaction strength. Experimental limits on a P-even/T-odd interaction are much less stringent. Following the standard approach of describing the nucleon-nucleon interaction in terms of meson exchanges, it can be shown that only charged rho-meson exchange and A 1 -meson exchange can lead to a P-even/T-odd interaction. The better constraints stem from measurements of the electric dipole moment of the neutron and from measurements of charge-symmetry breaking in neutron-proton elastic scattering. The latter experiments were executed at TRIUMF (497 and 347 MeV) and at IUCF (183 MeV). Weak decay experiments may provide limits which will possibly be comparable.
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