Early Thimerosal Exposure and Neuropsychological Outcomes

93 treated with oral melphalan plus high-dose oral dexamethasone, the 3-year overall survival rate was 80%, showing that they were actually “good risk” patients. With censoring of data for patients who died early and patients who could not receive their assigned treatment, the results of the landmark analysis strongly argued against the superiority of high-dose melphalan, even in groups with 0% treatment-related mortality and 100% treatment feasibility. This probably resulted from the very similar hematologic response rates in the two treatment groups, in a disease in which a clonal response is mandatory for improved survival. Our 24% rate of treatment-related mortality with high-dose melphalan is in keeping with the results of several other multicenter studies and can be considered as representative of the results with high-dose melphalan when used outside some tertiary referral centers. The better results obtained in these referral centers probably reflect not only better management of the disease but also better selection of candidates for high-dose melphalan. Both were likely factors in the impressive