Bortezomib/Adriamycine/Melfalan/Prednisone (VAMP)/Thalidomide/Cyclophosphamide/Dexamethasone (TaCyDex) or Bortezomib/Melfalan/Prednisone (V-MP)/TaCyDex) in Refractary or Relapsed Multiple Myeloma

Thalidomide-Cyclophosphamide-Dexamethasone in Patients < 75 Years or Velcade-Melfalan-Prednisone (V-MP)/Thalidomide-Cyclophosphamide-Dexamethasone in Patients >75 Years, in Refractary or Relapsed Multiple Myeloma

Multicentric study, open, single arm, designed to evaluate the efficacy(response rate and response duration) and security of a sequential scheme of treatment with Bortezomib in combination with Melfalan and Prednisone (V-MP) (patients > 75 years) or Bortezomib and Adriamycine in combination with Melfalan and Prednisone (VAMP) (patients <= 75 years) follow by Thalidomide in combination with Cyclophosphamide and Dexamethasone (TaCyDex) in patients with refractary or relapse multiple myeloma.

Multicentric study, open, single arm, designed to evaluate the efficacy(response rate and response duration) and security of a sequential scheme of treatment with Bortezomib in combination with Melfalan and Prednisone (V-MP) (patients > 75 years) or Bortezomib and Adriamycine in combination with Melfalan and Prednisone (VAMP) (patients <= 75 years) follow by Thalidomide in combination with Cyclophosphamide and Dexamethasone (TaCyDex) in patients with refractary or relapse multiple myeloma.

Inclusion Criteria:

• Patients with refractary or relapsed multiple myeloma
• ECOG ≤ 3
• Life expectancy > 3 months
• Neutrophils account ≥ 0.5 X 10^9/L, platelets ≥ 30 X 10^9/L.
• Transaminases <3 times upper normal limit, bilirubin < 2 times upper normal limit
• Age > 18 years
• Time after last chemotherapy or radiotherapy > 1 month or time after transplantation > 2 months.
• No possible other actual treatment
• Written consent form

Exclusion Criteria:

• Candidate to second transplantation
• No following criteria
• Other neoplasties
• Peripheral neuropathy > Grade 2.
• Previous ileus paralytic
• Hepatic failure
• No controlled infection
• No controlled high calcium levels
• Any organic insufficiency that no permit follow the correct treatment
• Pregnancy, breast feeding or fertility without anticonceptive method
• Any psychological, social and/or familiar event that no permit follow the correct treatment
• Diabetes mellitus not controled