Highdose Dexamethasone Monotherapy

Dexamethasone, 20 mg/m2/day on days 1-4, 9-12, and 17-20, induces responses in previously untreated patients with MM 40-50% of the time,55, 56 suggesting that dexamethasone accounts for most of the benefit derived from VAD and TD (described below). Dexamethasone monotherapy may be preferred for frail patients, since the toxicity is generally less than that seen with VAD or TD. Still, primary pulse dexam-ethasone treatment is somewhat more toxic than MP,57 and patients should be monitored closely for specific side effects, including hyperglycemia, gastrointestinal bleeding, mood disorder, insomnia, weight gain, increased susceptibility to infections, and rarely pancreatitis.58

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