Total Therapy is the name of an approach to therapy of which three successive versions have been tested and reported.The term “total therapy” as applied to multiple myeloma means the application at any given time of all agents and modalities that show efficacy against the disease, with the goal of reducing tumor burden maximally up front. The version used here in Total Therapy II. The projections for Total Therapy 3 included a greater-than-50% 10-year event-free survival rate and a greater-than-60% 10-year continuing complete response rate. The incorporation, therefore, of novel therapies into the total therapy paradigm has overcome adverse cytogenetics and achieved results heretofore not observed in multiple myeloma.
Still, none of these regimens have been prospectively studied and anone are recommended in standard guideliens, including NCCN, p.17 of the myeloma guideline.
. M. Lazarus, G. L. Phillips, R. H. Herzig, D. D. Hurd, S. N. Wolff, and G. P. Herzig
High-Dose Melphalan and the Development of Hematopoietic Stem-Cell Transplantation: 25 Years Later
J. Clin. Oncol., May 10, 2008; 26(14): 2240 - 2243.
http://static.cjp.com/gems/blood/ABMT-XI/Chapter02/Barlogie.PDF
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