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1. Riccardi A, Mora O, Tinelli C, Valentini D, Brugnatelli S, Spanedda R, De Paoli A, Barbarano L, Di Stasi M, Giordano M, Delfini C, Nicoletti G, Bergonzi C, Rinaldi E, Piccinini L, Ascari E: Long-term survival of stage I multiple myeloma given chemotherapy just after diagnosis or at progression of the disease: a multicentre randomized study. Cooperative Group of Study and Treatment of Multiple Myeloma. Br J Cancer; 2000 Apr;82(7):1254-60
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  • [Title] Long-term survival of stage I multiple myeloma given chemotherapy just after diagnosis or at progression of the disease: a multicentre randomized study. Cooperative Group of Study and Treatment of Multiple Myeloma.
  • We conducted a randomized trial to evaluate whether melphalan-prednisone (MPH-P) treatment administered just after diagnosis improves survival of stage I multiple myeloma (MM).
  • Between January 1987 and March 1993, 145 consecutive previously untreated patients with stage I MM were randomized between treatment with MPH-P (administered for 4 days every 6 weeks) just after diagnosis and treatment only at disease progression.
  • Survival was not influenced by MPH-P treatment either administered just after diagnosis or at disease progression (64 vs 71 months respectively).
  • Patients actually treated at disease progression (34/70) survived shorter than those who had neither disease progression nor treatment (56 vs > 92 months; P = 0.005).
  • Starting MPH-P just after diagnosis does not improve survival and response rate in stage I MM, with respect to deferring therapy until disease progression.
  • However, patients with stage I MM randomized to have treatment delayed and who actually progressed and were treated had shorter survival than those with stable disease and no treatment.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Multiple Myeloma / drug therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Disease Progression. Female. Humans. Male. Melphalan / administration & dosage. Middle Aged. Prednisone / administration & dosage. Prognosis. Survival Analysis. Time Factors. Treatment Outcome

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  • (PMID = 10755397.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] SCOTLAND
  • [Chemical-registry-number] Q41OR9510P / Melphalan; VB0R961HZT / Prednisone; AP protocol 2
  • [Other-IDs] NLM/ PMC2374495
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2. Novitzky N, Thomson J, Thomas V, du Toit C, Mohamed Z, McDonald A: Combined submyeloablative and myeloablative dose intense melphalan results in satisfactory responses with acceptable toxicity in patients with multiple myeloma. Biol Blood Marrow Transplant; 2010 Oct;16(10):1402-10
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  • [Title] Combined submyeloablative and myeloablative dose intense melphalan results in satisfactory responses with acceptable toxicity in patients with multiple myeloma.
  • We studied in patients with multiple myeloma (MM) the efficacy, cost-effectiveness, and toxicity of a strategy of submyeloablative doses of Mel and stem cell support in the ambulatory setting, followed by a standard myeloablative dose transplant.
  • Twenty-six female and 16 male patients, with a median age of 53 years (range: 33-68 years) and median Salmon & Durie clinical disease stage III (range: II-III) were studied.
  • The median cost of MEL100 and corresponding supportive therapy was U.S. $2,142.35.
  • At a median follow-up of 659 days there were 8 deaths, 1 (2%) was related to the treatment procedures and 6 from disease progression; thus, the 1000 days OS was 73%.
  • Importantly, these satisfactory results were obtained in the absence of the new biologic cell modifiers.
  • [MeSH-major] Melphalan / administration & dosage. Multiple Myeloma / surgery. Myeloablative Agonists / administration & dosage. Peripheral Blood Stem Cell Transplantation / statistics & numerical data. Transplantation Conditioning / methods
  • [MeSH-minor] Adult. Aged. Ambulatory Care / economics. Combined Modality Therapy. Dexamethasone / therapeutic use. Disease Progression. Disease-Free Survival. Drug Costs. Female. Filgrastim. Follow-Up Studies. Granulocyte Colony-Stimulating Factor / pharmacology. Hospital Costs. Humans. Karnofsky Performance Status. Male. Middle Aged. Recombinant Proteins. Remission Induction. South Africa. Survival Analysis. Transplantation, Autologous. Treatment Outcome

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  • [Copyright] Copyright © 2010 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.
  • (PMID = 20385248.001).
  • [ISSN] 1523-6536
  • [Journal-full-title] Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
  • [ISO-abbreviation] Biol. Blood Marrow Transplant.
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Myeloablative Agonists; 0 / Recombinant Proteins; 143011-72-7 / Granulocyte Colony-Stimulating Factor; 7S5I7G3JQL / Dexamethasone; PVI5M0M1GW / Filgrastim; Q41OR9510P / Melphalan
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3. Kim JM, Lee JA, Cho IS, Ihm CH: Soluble syndecan-1 at diagnosis and during follow up of multiple myeloma: a single institution study. Korean J Hematol; 2010 Jun;45(2):115-9
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  • [Title] Soluble syndecan-1 at diagnosis and during follow up of multiple myeloma: a single institution study.
  • BACKGROUND: Syndecan-1 is a heparan sulfate proteoglycan expressed on plasma cells, especially myeloma cells, and can exist in serum as soluble syndecan-1 after shedding from the cell surface.
  • Soluble syndecan-1 has been suggested to promote myeloma cell growth and to be an independent prognostic factor for multiple myeloma.
  • We aimed to evaluate the effect of soluble syndecan-1 levels at the time of diagnosis and during therapy on therapeutic response and prognosis for patients with multiple myeloma.
  • METHODS: We analyzed soluble syndecan-1 levels in 28 patients with multiple myeloma and 50 normal controls, and compared its levels with Durie-Salmon stage and other markers of myeloma.
  • In addition, we evaluated the therapeutic response and determined the 3-year survival rates of these patients.
  • RESULTS: We observed that the median soluble syndecan-1 level in myeloma patients was higher than that in the normal controls (P <0.0001), and the soluble syndecan-1 levels in 21 (75%) patients were higher than the cut-off level (162 ng/mL).
  • Soluble syndecan-1 levels correlated with disease stage, percentage of plasma cells in the bone marrow, β(2) microglobulin level, serum M-component concentration, and creatinine level.
  • The baseline levels of soluble syndecan-1 at the time of diagnosis in the patients who responded to chemotherapy were lower than those in the non-responders (P=0.04); however, the baseline level was not a significant predictor of therapeutic response.
  • The 3-year overall survival rate of the patients with high soluble syndecan-1 levels at the time of diagnosis and 6 months after chemotherapy was lower than the corresponding survival rates of the patients with low levels of soluble syndecan-1; however, the overall survival rate was not statistically significant.
  • CONCLUSION: The use of soluble syndecan-1 has limitations in the diagnosis of multiple myeloma.
  • Soluble syndecan-1 levels correlate with known prognostic factors; however, we could not assess the prognostic value of high levels of soluble syndecan-1 at the time of diagnosis and after chemotherapy.

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  • (PMID = 21120190.001).
  • [ISSN] 2092-9129
  • [Journal-full-title] The Korean journal of hematology
  • [ISO-abbreviation] Korean J Hematol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Korea (South)
  • [Other-IDs] NLM/ PMC2983025
  • [Keywords] NOTNLM ; Multiple myeloma / Prognosis / Syndecan-1
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4. Le Blanc R, Montminy-Métivier S, Bélanger R, Busque L, Fish D, Roy DC, Kassis J, Boileau J, Lavallée R, Bélanger D, Letendre F, Hébert J, Sauvageau G, Perreault C, Roy J: Allogeneic transplantation for multiple myeloma: further evidence for a GVHD-associated graft-versus-myeloma effect. Bone Marrow Transplant; 2001 Nov;28(9):841-8
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  • [Title] Allogeneic transplantation for multiple myeloma: further evidence for a GVHD-associated graft-versus-myeloma effect.
  • We report a series of 37 consecutive patients with multiple myeloma (MM) who received an allograft between 1990 and 2000 at our institution.
  • Median age was 47 years, and nearly 70% of patients were Durie-Salmon stage III.
  • A median of five cycles of chemotherapy were given before transplant, with a median interval between diagnosis and transplant of 9.3 months.
  • Treatment failure rate and overall survival at 40 months are estimated at 52% and 32%, respectively.
  • The number of chemotherapy cycles prior to allotransplantation achieved borderline statistical significance as a poor prognosis factor for overall survival (P = 0.05), while the presence of chronic graft-versus-host disease (cGVHD) was significantly correlated with CR achievement (P = 0.036).
  • More importantly, our study clearly demonstrates an association between cGVHD and CR and brings further evidence in favor of a graft-versus-myeloma effect.
  • [MeSH-major] Bone Marrow Transplantation. Graft vs Host Disease / immunology. Graft vs Tumor Effect. Multiple Myeloma / therapy
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy. Cyclophosphamide / administration & dosage. Dexamethasone / administration & dosage. Doxorubicin / administration & dosage. Humans. Life Tables. Melphalan / administration & dosage. Middle Aged. Prednisone / administration & dosage. Remission Induction. Retrospective Studies. Survival Analysis. Survival Rate. Transplantation, Homologous / immunology. Treatment Outcome. Vincristine / administration & dosage

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  • (PMID = 11781644.001).
  • [ISSN] 0268-3369
  • [Journal-full-title] Bone marrow transplantation
  • [ISO-abbreviation] Bone Marrow Transplant.
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] England
  • [Chemical-registry-number] 5J49Q6B70F / Vincristine; 7S5I7G3JQL / Dexamethasone; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; Q41OR9510P / Melphalan; VB0R961HZT / Prednisone; CHOP protocol; VAD protocol
  • [Number-of-references] 38
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5. Ben Abid H, Meddeb B, Ben Abdallah M, Bel Hadj Ali Z, Hafsia R, Ben Lakhal R, Gouider E, Aissaoui L, Landoulsi I, ben Abdeladhim A, Hafsia A: [Long-term survival and prognostic factors in multiple myeloma treated with conventional chemotherapy. Report of 109 cases]. Tunis Med; 2000 Dec;78(12):705-12
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  • [Title] [Long-term survival and prognostic factors in multiple myeloma treated with conventional chemotherapy. Report of 109 cases].
  • [Transliterated title] Survie a long terme et facteurs pronostiques du myelome multiple traite par chimiotherapie conventionnelle. A propos de 109 cas.
  • We report the results of conventional chemotherapy ins previosly untreated patients with myeloma.
  • The median age was 65 years, 87 patients (80%) were including in the stage III according the Durie Salmon staging system.
  • The median survival time was 27 months and 10 years survival rate is 3.66%.
  • The study suggest that conventional therapy is a good treatment for old patients.
  • However, patients younger than 55 years, must benefit from intensive chemotherapy supported by autologous bone marrow, pheripheral blood stem cells, or allogenic bone marrow transplantation.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Multiple Myeloma / drug therapy
  • [MeSH-minor] Adult. Age Factors. Aged. Aged, 80 and over. Bone Marrow Transplantation. Female. Hematopoietic Stem Cell Transplantation. Humans. Male. Middle Aged. Prognosis. Retrospective Studies. Survival Analysis

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  • (PMID = 11155374.001).
  • [ISSN] 0041-4131
  • [Journal-full-title] La Tunisie médicale
  • [ISO-abbreviation] Tunis Med
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Tunisia
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6. Chen C, Reece DE, Siegel D, Niesvizky R, Boccia RV, Stadtmauer EA, Abonour R, Richardson P, Matous J, Kumar S, Bahlis NJ, Alsina M, Vescio R, Coutre SE, Pietronigro D, Knight RD, Zeldis JB, Rajkumar V: Expanded safety experience with lenalidomide plus dexamethasone in relapsed or refractory multiple myeloma. Br J Haematol; 2009 Jul;146(2):164-70
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  • [Title] Expanded safety experience with lenalidomide plus dexamethasone in relapsed or refractory multiple myeloma.
  • Lenalidomide gained Food and Drug Administration (FDA) approval for treatment of patients with relapsed or refractory multiple myeloma (MM) in combination with dexamethasone in June 2006.
  • Relapsed/refractory MM patients received lenalidomide 25 mg/d (days 1-21) and dexamethasone 40 mg/d (days 1-4, 9-12, and 17-20 of cycles 1-4; days 1-4 only from cycle 5 onwards), in 4-week cycles until disease progression, study drug discontinuation, or lenalidomide approval.
  • Of the 1438 patients enrolled, approximately 60% were male, median age was 64 years, and 61.7% had Durie-Salmon stage III disease.
  • Median time on study was 15.4 weeks (range: 0.1-49.1) and median dose was 25 mg.
  • Safety data confirmed known AEs of lenalidomide plus dexamethasone therapy in patients with relapsed/refractory MM.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Multiple Myeloma / drug therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Dexamethasone / administration & dosage. Dexamethasone / adverse effects. Drug Resistance, Neoplasm. Female. Humans. Male. Middle Aged. Recurrence. Thalidomide / administration & dosage. Thalidomide / adverse effects. Thalidomide / analogs & derivatives. Treatment Outcome

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  • (PMID = 19545290.001).
  • [ISSN] 1365-2141
  • [Journal-full-title] British journal of haematology
  • [ISO-abbreviation] Br. J. Haematol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 4Z8R6ORS6L / Thalidomide; 7S5I7G3JQL / Dexamethasone; F0P408N6V4 / lenalidomide
  • [Other-IDs] NLM/ PMC2728892
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7. Kuku I, Bayraktar MR, Kaya E, Erkurt MA, Bayraktar N, Cikim K, Aydogdu I: Serum proinflammatory mediators at different periods of therapy in patients with multiple myeloma. Mediators Inflamm; 2005 Aug 14;2005(3):171-4
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  • [Title] Serum proinflammatory mediators at different periods of therapy in patients with multiple myeloma.
  • Multiple myeloma (MM) is a malignant disease characterized by the clonal proliferation of plasma cells within the bone marrow.
  • The median age of the patients was 63.4 +/- 10.8 years and all of the patients were stage III (classified according to the Durie-Salmon classification).
  • In addition, we also examined the effects of vincristine-adriamycin-dexamethasone (VAD) therapy on the same parameters and mediators as well as the relationship among the parameters in the same patient groups.
  • All of the parameters were found to be significantly reduced after chemotherapy.
  • In conclusion, we found that after the VAD therapy, the level of these cytokines which are thought to play an important role in the pathogenesis of MM was significantly suppressed.
  • This is the first study demonstrating strong impact of VAD treatment on circulating mediators of sIL-2R and IL-8 levels parameters.
  • [MeSH-major] C-Reactive Protein / metabolism. Interleukin-1 / blood. Interleukin-6 / blood. Interleukin-8 / blood. Multiple Myeloma. Receptors, Interleukin-2 / blood. Tumor Necrosis Factor-alpha / metabolism
  • [MeSH-minor] Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Dexamethasone / therapeutic use. Doxorubicin / therapeutic use. Female. Humans. Male. Middle Aged. Vincristine / therapeutic use

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  • (PMID = 16106104.001).
  • [ISSN] 0962-9351
  • [Journal-full-title] Mediators of inflammation
  • [ISO-abbreviation] Mediators Inflamm.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Interleukin-1; 0 / Interleukin-6; 0 / Interleukin-8; 0 / Receptors, Interleukin-2; 0 / Tumor Necrosis Factor-alpha; 5J49Q6B70F / Vincristine; 7S5I7G3JQL / Dexamethasone; 80168379AG / Doxorubicin; 9007-41-4 / C-Reactive Protein; VAD protocol
  • [Other-IDs] NLM/ PMC1526466
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8. Anagnostopoulos A, Aleman A, Ayers G, Donato M, Champlin R, Weber D, Alexanian R, Giralt S: Comparison of high-dose melphalan with a more intensive regimen of thiotepa, busulfan, and cyclophosphamide for patients with multiple myeloma. Cancer; 2004 Jun 15;100(12):2607-12
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  • [Title] Comparison of high-dose melphalan with a more intensive regimen of thiotepa, busulfan, and cyclophosphamide for patients with multiple myeloma.
  • BACKGROUND: High-dose chemotherapy (HDC) with autologous stem cell transplantation (ASCT) as part of the initial treatment regimen improves progression-free survival (PFS) and overall survival (OS) for patients with multiple myeloma.
  • The optimal preparative regimen for patients with multiple myeloma has yet to be defined.
  • In the current study, the authors compared the outcomes associated with high-dose melphalan (HDM) and a more intensive regimen of thiotepa, busulfan, and cyclophosphamide (TBC) in patients with multiple myeloma.
  • METHODS: One hundred eighty-six patients with newly diagnosed multiple myeloma (median age, 51 years) received HDC with ASCT for consolidation of first remission (n = 108) or for treatment of primary refractory disease (n = 78).
  • Seventy patients had a large tumor mass at the time of diagnosis.
  • Patients in the TBC group were younger and had more advanced disease stage at diagnosis and at the time of ASCT compared with patients in the HDM group.
  • A proportional hazards regression model revealed that Durie-Salmon disease stage at diagnosis and having received three or more previous treatment regimens were the only factors that predicted PFS; the type of preparative regimen did not influence outcome.
  • CONCLUSIONS: The results of the current study indicate that the use of a more intensive regimen did not improve results compared with HDM in patients with multiple myeloma.
  • HDM should continue to be considered the standard preparative regimen for patients with myeloma.
  • [MeSH-major] Antineoplastic Agents, Alkylating / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Melphalan / administration & dosage. Multiple Myeloma / drug therapy
  • [MeSH-minor] Adult. Aged. Busulfan / administration & dosage. Cyclophosphamide / administration & dosage. Disease-Free Survival. Humans. Middle Aged. Retrospective Studies. Thiotepa / administration & dosage. Treatment Outcome

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  • [Copyright] Copyright 2004 American Cancer Society.
  • (PMID = 15197803.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; 8N3DW7272P / Cyclophosphamide; 905Z5W3GKH / Thiotepa; G1LN9045DK / Busulfan; Q41OR9510P / Melphalan
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9. Adam Z, Krejcí M, Pour L, Stepánková S, Cermáková Z, Voska L, Teplan V, Krivanová A, Hájek R, Mayer J: [Complete remission of nephrotic syndrome and improvement of renal function in a patient with light chain deposition disease following high dose chemotherapy with transplantation of autologous haematopoietic stem cells. A case study and review of literature]. Vnitr Lek; 2009 Nov;55(11):1089-96
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  • [Title] [Complete remission of nephrotic syndrome and improvement of renal function in a patient with light chain deposition disease following high dose chemotherapy with transplantation of autologous haematopoietic stem cells. A case study and review of literature].
  • Bone marrow biopsy contained 40% of plasma cells.
  • These findings confirmed the diagnosis of multiple myeloma (MM) Durie Salmon stage IB with LCDD.
  • The patient was initially treated with 4 cycles of VAD (vinkristine, adriamycine, dexamethasone) chemotherapy with no response.
  • Followed collection of peripheral haematopoietic stem cells and later high dose chemotherapy with reduced dose of melphalan 140 mg/sqm and autologous peripheral haematopoietic stem cells transplantation.
  • High dose therapy was complicated by with deterioration of renal function, creatinine increased to 600 micromol/l.
  • Follow-up examination one month after high dose chemotherapy showed complete remission, that was confirmed by further examinations.
  • In the course of the first year after high dose chemotherapy renal function gradually improved and nephrotic syndrome completely disappeared (complete kidney remission).
  • Three years after high dose chemotherapy the patient is still in complete remission of multiple myeloma and free of nephrotic syndrome, with slightly increased creatinine (160 micromol/l) that, nevertheless, has had an improving tendency over last 3 years.
  • The present case study illustrates accomplishment of complete haematological remission with high dose chemotherapy followed by autologous haematopoietic stem cells transplantation despite complete resistance of the disease to the standard chemotherapy VAD in a patient with MM and LCDD.
  • We draw the reader's attention to the possibility of nephrotoxic effects of high dose melphalan (post conditioning renal insufficiency) in patients with nephrotic syndrome caused by light chain deposits as AL-amyloid or amorphous light chains deposits (LCDD)and we document the importance of plasma free light chain detection.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Hematopoietic Stem Cell Transplantation. Immunoglobulin Light Chains / immunology. Multiple Myeloma / therapy. Nephrotic Syndrome / physiopathology
  • [MeSH-minor] Adult. Antineoplastic Agents, Alkylating / administration & dosage. Antineoplastic Agents, Alkylating / adverse effects. Combined Modality Therapy. Drug Resistance, Neoplasm. Female. Humans. Kidney / pathology. Melphalan / administration & dosage. Melphalan / adverse effects. Remission Induction. Transplantation, Autologous

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  • (PMID = 20017442.001).
  • [ISSN] 0042-773X
  • [Journal-full-title] Vnitr̆ní lékar̆ství
  • [ISO-abbreviation] Vnitr Lek
  • [Language] cze
  • [Publication-type] Case Reports; English Abstract; Journal Article; Review
  • [Publication-country] Czech Republic
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; 0 / Immunoglobulin Light Chains; Q41OR9510P / Melphalan
  • [Number-of-references] 48
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10. Scudla V, Zemanova M, Minarik J, Bacovsky J, Ordeltova M, Indrak K, Budikova M, Dusek L, Farbiakova V: International prognostic index (IPI)--a critical comparison with five multiple myeloma staging systems in the group of 270 patients treated by conventional chemotherapy. Neoplasma; 2006;53(4):277-84
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  • [Title] International prognostic index (IPI)--a critical comparison with five multiple myeloma staging systems in the group of 270 patients treated by conventional chemotherapy.
  • In the group of 270 patients with multiple myeloma (MM) treated during 1991-2004 by conventional chemotherapy, the prognostic value and practical utility of IPI (International Prognostic Index) was assessed and compared with five other actual staging systems.
  • Good practical utility and prognostic significance of Durie-Salmon (D-S) system was confirmed (p<0.001).
  • Regardless of a short 5-year duration of the study, the scoring system according to San Miguel enclosing apart from other parameters also propidium iodide proliferation index (PC-PI) of myeloma plasmocytes seems to be promising with very different characteristics of curves of overall survival (p<0.001).
  • With regard to detection of patients of stage 1, i. e. "low risk", not requiring an immediate initiation of conventional chemotherapy ("wait and see" approach), the most suitable was the system according to D-S, SWOG and IPI (median OS 77, 76 and 77 months).
  • To select a cohort of "high risk" patients, i.e. stage 3, with very unfavourable disease prognosis, the most advantageous was the system OSS and San Miguel (median OS was 5 and 6 months) and/or SWOG system selecting patients of stage 4, i.e.
  • It was found that IPI did not meet expectations for effective identification of "high risk" patients (median OS of stage 3 was 20 months) nor for the distinction of different prognosis of patients during initial 25 months of MM course at stage 2 vs. 3.
  • The study indicates that under conditions of common clinical practice and conventional chemotherapy, the staging system according to D-S is still useful, while practical application of SWOG and IPI as simpler alternative to the assessment of clinical stage should be verified by further comparative studies.
  • In harmony with the progress in cytogenetics and molecular biology as well as a prospective requirement of individual target therapy, a future suitable stratification system should be based on parameters of internal biological properties of myeloma tissue and microenvironment of bone marrow, allowing in addition a continuous evaluation of the disease course and the effect of therapy.
  • [MeSH-major] Multiple Myeloma / diagnosis. Neoplasm Staging


11. Buchler T, Krejci M, Svobodnik A, Adam Z, Minarik J, Bacovsky J, Scudla V, Mayer J, Vorlicek J, Hajek R: Outcome of patients with multiple myeloma and hypertension treated with angiotensin-I-converting enzyme inhibitors during high-dose chemotherapy. Hematol J; 2005;5(7):559-64
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  • [Title] Outcome of patients with multiple myeloma and hypertension treated with angiotensin-I-converting enzyme inhibitors during high-dose chemotherapy.
  • In a retrospective study we have sought to determine whether the administration of angiotensin-I-converting enzyme inhibitors (ACEI) influences the outcome of patients with multiple myeloma (MM).
  • Patients with MM who underwent autologous peripheral blood stem cell transplantation (PBSCT) (n=168) were studied.
  • Patients from the non-ACEI group (n=143; 85%) were taking other or no antihypertensive medication.
  • There were no significant differences between the studied groups in standard prognostic parameters for MM (age, albumin, beta 2-microglobulin, IPI and Durie-Salmon stage, LDH, CRP, performance status) or in engraftment.
  • The mortality in our study has been mostly myeloma related.

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  • (PMID = 15692600.001).
  • [ISSN] 1466-4860
  • [Journal-full-title] The hematology journal : the official journal of the European Haematology Association
  • [ISO-abbreviation] Hematol. J.
  • [Language] ENG
  • [Publication-type] Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Angiotensin-Converting Enzyme Inhibitors; 0 / Antihypertensive Agents
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12. Hillengass J, Ho AD, Goldschmidt H, Waldherr R, Moehler TM: Clinical evidence for immunomodulation induced by high-dose melphalan and autologous blood stem cell transplantation as cause for complete clinical remission of multiple myeloma-associated cryoglobulin-vasculitis. Int J Hematol; 2008 Nov;88(4):454-6
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  • [Title] Clinical evidence for immunomodulation induced by high-dose melphalan and autologous blood stem cell transplantation as cause for complete clinical remission of multiple myeloma-associated cryoglobulin-vasculitis.
  • We present a case report of a patient with cryoglobulin-vasculitis caused by multiple myeloma in Durie/Salmon stage I refractory to conventional therapy modalities treated with high-dose chemotherapy followed by autologous blood stem cell transplantation.
  • Therefore we conclude that the relief of symptoms was caused by an immunomodulation induced by the autologous stem cell transplantation.
  • [MeSH-major] Antineoplastic Agents, Alkylating / administration & dosage. Cryoglobulins. Melphalan / administration & dosage. Multiple Myeloma / therapy. Peripheral Blood Stem Cell Transplantation. Vasculitis / therapy


13. Pouye A, Ka MM, Diallo S, Fall S, Dia D, Ndongo S, Leye A, Diop MT: [A multiple myeloma long term survival case]. Tunis Med; 2004 Jun;82(6):538-41
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  • [Title] [A multiple myeloma long term survival case].
  • [Transliterated title] Survie prolongee au cours du myelome multiple: à propos d'une observation.
  • Multiple myeloma is a malignant plasma cells proliferation in the bone marrow leading to a monoclonal immunoglobulin hypersecretion.
  • The radiologic findings observed were multiple fractures.
  • The bone marrow aspiration confirmed the plasmocytosis greater than 50%, with immature plasma cells and other lineages rarefication.
  • The disease belonged to the stage III A of the Salmon and Durie classification.
  • Chemotherapy with melphalan associated to prednisone was started with a two to three months biological and clinical follow-up.
  • This treatment allowed 12 years survival.
  • [MeSH-major] Multiple Myeloma / therapy
  • [MeSH-minor] Adult. Fatal Outcome. Female. Humans. Survivors. Time Factors

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  • (PMID = 15517953.001).
  • [ISSN] 0041-4131
  • [Journal-full-title] La Tunisie médicale
  • [ISO-abbreviation] Tunis Med
  • [Language] fre
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Tunisia
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14. He Y, Wheatley K, Clark O, Glasmacher A, Ross H, Djulbegovic B: Early versus deferred treatment for early stage multiple myeloma. Cochrane Database Syst Rev; 2003;(1):CD004023
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  • [Title] Early versus deferred treatment for early stage multiple myeloma.
  • BACKGROUND: Early stage multiple myeloma (MM) represents about 20% of MM.
  • Thus, it is far less dramatic than advanced disease and may require different treatment strategies.
  • For these patients, it is not clear whether it is better to start chemotherapy right after the diagnosis or to delay the treatment until symptoms become obvious as the disease progresses.
  • OBJECTIVES: To identify and synthesize all available research evidence on whether early treatment intervention results in improved clinical outcomes when compared with observation alone.
  • The main outcomes of interest that were examined included mortality, disease progression, response rate, and toxicity of early treatment.
  • We have recently compiled a comprehensive database of RCTs in myeloma.
  • SELECTION CRITERIA: Randomized controlled trials (RCT) with a parallel design that compared early versus deferred treatment of patients with early stage multiple myeloma based on Durie-Salmon (D-S) staging system.
  • We also considered those trials that did not define early stage myeloma according to D-S staging system, but enrolled patients according to clinical uncertainty about the benefits of immediate intervention.
  • MAIN RESULTS: Three trials were included with a total of 131 patients in each of the early treatment and deferred treatment groups.
  • Early MM is asymptomatic stage I in these trials.
  • All trials used standard Melphalan treatment but not stem cell transplantation.
  • Beneficial effects of early treatment were seen in delay of myeloma progression (Peto's OR = 0.16, 95% CI: 0.09-0.29), and reduced vertebral compression (OR = 0.18, 95%CI: 0.02-1.59, NNT = 23, 95% CI: an NNT of 11, via infinity, to an NNH of 50).
  • Early treatment may increase the risk of acute leukemia (Peto's OR = 3.20, 95% CI: 0.55-18.73, NNH = 44, 95% CI: an NNT of 63, via infinity, to an NNH of 15).
  • REVIEWER'S CONCLUSIONS: Early treatment of early stage multiple myeloma inhibits disease progression, and may reduce vertebral compression.
  • However, early treatment may increase the risk of acute leukemia.
  • Based on the current evidence, mortality and response rate are not significantly affected by introducing early treatment in the progression of myeloma.
  • However, it is quite possible that the lack of beneficial effects of early intervention in myeloma is a false negative result due to the paucity of the existing evidence.
  • In addition, data on quality of life and toxicity were sparsely reported adding to additional difficulties about management decisions in early stage myeloma.
  • [MeSH-major] Multiple Myeloma / therapy
  • [MeSH-minor] Disease Progression. Humans. Randomized Controlled Trials as Topic. Time Factors

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  • (PMID = 12535504.001).
  • [ISSN] 1469-493X
  • [Journal-full-title] The Cochrane database of systematic reviews
  • [ISO-abbreviation] Cochrane Database Syst Rev
  • [Language] eng
  • [Publication-type] Journal Article; Meta-Analysis; Review
  • [Publication-country] England
  • [Number-of-references] 28
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15. Rodon P, Linassier C, Gauvain JB, Benboubker L, Goupille P, Maigre M, Luthier F, Dugay J, Lucas V, Colombat P: Multiple myeloma in elderly patients: presenting features and outcome. Eur J Haematol; 2001 Jan;66(1):11-7
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  • [Title] Multiple myeloma in elderly patients: presenting features and outcome.
  • Few studies have been performed regarding multiple myeloma (MM) in elderly patients.
  • Ninety-four patients received conventional chemotherapy.
  • Treatment toxicity was mild.
  • Durie-Salmon (DS) clinical stages II and III MM were severe and often led to death, while significantly more patients with DS stage I MM died from unrelated causes (p<0.0001).
  • Univariate analysis showed that age > or = 85 yr, performance status > or = 2, creatinine level > or = 120 micromol/l, beta 2 microglobulin level > 4 mg/l, C-reactive protein level > 6 mg/l, platelet count < 100 x 10(9)/l, presence of infection and lack of response to chemotherapy were adverse prognostic factors for survival.
  • This study provides evidence that in patients with symptomatic MM age should not be considered as a major obstacle to active treatment.
  • [MeSH-major] Multiple Myeloma / epidemiology
  • [MeSH-minor] Aged. Aged, 80 and over. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cause of Death. Comorbidity. Cyclophosphamide / administration & dosage. Dexamethasone / administration & dosage. Doxorubicin / administration & dosage. Etoposide / administration & dosage. Female. France / epidemiology. Humans. Interferon-alpha / administration & dosage. Life Tables. Lomustine / administration & dosage. Male. Melphalan / administration & dosage. Myeloma Proteins / analysis. Neoplasm Staging. Paraneoplastic Syndromes / epidemiology. Prednimustine / administration & dosage. Prednisone / administration & dosage. Prognosis. Proportional Hazards Models. Retrospective Studies. Survival Analysis. Treatment Outcome. Vincristine / administration & dosage

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  • (PMID = 11168502.001).
  • [ISSN] 0902-4441
  • [Journal-full-title] European journal of haematology
  • [ISO-abbreviation] Eur. J. Haematol.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study; Review
  • [Publication-country] Denmark
  • [Chemical-registry-number] 0 / Interferon-alpha; 0 / Myeloma Proteins; 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 7BRF0Z81KG / Lomustine; 7S5I7G3JQL / Dexamethasone; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; 9403SIO2S8 / Prednimustine; Q41OR9510P / Melphalan; VB0R961HZT / Prednisone; AP protocol 2; CEP protocol; VAD protocol; VMCP protocol
  • [Number-of-references] 26
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16. Palumbo A, Bertola A, Falco P, Rosato R, Cavallo F, Giaccone L, Bringhen S, Musto P, Pregno P, Caravita T, Ciccone G, Boccadoro M: Efficacy of low-dose thalidomide and dexamethasone as first salvage regimen in multiple myeloma. Hematol J; 2004;5(4):318-24
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  • [Title] Efficacy of low-dose thalidomide and dexamethasone as first salvage regimen in multiple myeloma.
  • PURPOSE: The efficacy of low-dose thalidomide (THAL) plus dexamethasone (DEX) has been evaluated in myeloma.
  • The clinical outcome of patients treated with THAL-DEX was compared with that of a control group treated with conventional chemotherapy (CC).
  • EXPERIMENTAL DESIGN: A total of 120 relapsed/refractory patients to one (52%), or two or more(48%) lines of chemotherapy were treated with THAL 100mg/day (continuous) and DEX 40 mg (days 1-4 of each month).
  • Their clinical outcome was compared to a control group of 120 patients frequency matched for serum beta2-microglobulin levels and Durie and Salmon clinical stage.
  • RESULTS: In patients treated after one line of chemotherapy, THAL-DEX significantly improved outcome.
  • The clinical outcome of patients receiving THAL-DEX or CC after two or more lines of chemotherapy, was similar.
  • It postpones the delivery of effective salvage chemotherapy.

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  • (PMID = 15297848.001).
  • [ISSN] 1466-4860
  • [Journal-full-title] The hematology journal : the official journal of the European Haematology Association
  • [ISO-abbreviation] Hematol. J.
  • [Language] ENG
  • [Publication-type] Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 4Z8R6ORS6L / Thalidomide; 7S5I7G3JQL / Dexamethasone
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17. Shustik C, Belch A, Robinson S, Rubin S, Dolan S, Kovacs M, Djurfeldt M, Shepherd L, Ding K, Meyer RM: Dexamethasone (dex) maintenance versus observation (obs) in patients with previously untreated multiple myeloma: A National Cancer Institute Of Canada Clinical Trials Group Study: MY.7. J Clin Oncol; 2004 Jul 15;22(14_suppl):6510

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  • [Title] Dexamethasone (dex) maintenance versus observation (obs) in patients with previously untreated multiple myeloma: A National Cancer Institute Of Canada Clinical Trials Group Study: MY.7.
  • : 6510 Background: DEX is an active drug in patients with previously untreated or relapsed multiple myeloma (MM).
  • We conducted a phase III trial comparing DEX vs. prednisone in combination with melphalan as induction therapy; and pulsed monthly DEX vs. OBS as maintenance in previously untreated patients (pts) with MM.
  • No differences in outcomes were observed in induction (ASCO 2001); we now report the results of maintenance therapy.
  • METHODS: Patients with symptomatic Durie-Salmon stage I, or stage II/III previously untreated MM were randomized to one of 2 induction regimens given for 12 cycles: arms 1 and 2 -melphalan 9mg/m2 po and prednisone 100 mg po daily for 4 days q 4 weeks; arms 3 and 4 - melphalan as above and DEX 40 mg for 4 days q 4 weeks.
  • Pts were balanced in baseline patient and disease-related characteristics, and response to induction therapy.
  • CONCLUSION: DEX as monthly pulsed therapy following induction with a melphalan-based regimen improves PFS but not OS in previously untreated patients with MM.
  • These results should be considered in the design of future trials assessing maintenance therapy.

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  • (PMID = 28016923.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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18. Knauf W, Kellermann L, Poenisch W, Einsele H, Straka C, Frohn C, Goldschmidt H: How to treat multiple myeloma - a representative multicentre treatment survey. Onkologie; 2010;33(11):604-10
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  • [Title] How to treat multiple myeloma - a representative multicentre treatment survey.
  • BACKGROUND: The present survey was undertaken to gain insights in the changes of disease management of multiple myeloma (MM) over time and the implementation of new guidelines into daily practice.
  • PATIENTS AND METHODS: Diagnosis and treatment of MM were evaluated based on a 3-month representative multicentre survey including 386 patients from 35 centres in Germany in 2008.
  • RESULTS: At the time of first diagnosis, most patients (62.5%) were already in stage III (Durie-Salmon).
  • Overall, 35% of patients were considered for high-dose chemotherapy.
  • As a consequence of the development of innovative substances, there are remarkable shifts in first line, second line, and third line therapy with an increase in the use of bortezomib at all levels of therapy.
  • Also, high-dose chemotherapy with stem cell support was considered in a minority of patients only.
  • Novel substances, however, were rapidly integrated into the treatment of MM.
  • [MeSH-major] Drug Therapy / utilization. Multiple Myeloma / epidemiology. Multiple Myeloma / therapy. Practice Patterns, Physicians' / statistics & numerical data. Stem Cell Transplantation / utilization
  • [MeSH-minor] Aged. Aged, 80 and over. Female. Germany / epidemiology. Humans. Incidence. Male. Middle Aged. Treatment Outcome

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  • [Copyright] Copyright © 2010 S. Karger AG, Basel.
  • [CommentIn] Onkologie. 2010;33(11):577-8 [20975302.001]
  • (PMID = 20975307.001).
  • [ISSN] 1423-0240
  • [Journal-full-title] Onkologie
  • [ISO-abbreviation] Onkologie
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] Switzerland
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19. Schaar CG, Kluin-Nelemans JC, le Cessie S, Franck PF, te Marvelde MC, Wijermans PW: Early response to therapy and survival in multiple myeloma. Br J Haematol; 2004 Apr;125(2):162-6
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  • [Title] Early response to therapy and survival in multiple myeloma.
  • Whether the response to chemotherapy is a prognosticator in multiple myeloma (MM) is still not known.
  • Therefore, the relationship between survival and the rate of monoclonal protein (M-protein) decrement during the first cycles of therapy was prospectively assessed in 262 patients with newly diagnosed MM that were included in a phase III trial (HOVON-16).
  • M-proteins were collected monthly during melphalan-prednisone therapy (MP: melphalan 0.25 mg/kg, prednisone 1.0 mg/kg orally for 5 d every 4 weeks).
  • As established prognostic parameters (Salmon & Durie stage, serum creatinine, and haemoglobin) also remained prognostically significant, we concluded that early response to MP predicts for survival in MM.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Multiple Myeloma / drug therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Immunoglobulin A / metabolism. Immunoglobulin G / metabolism. Male. Melphalan / administration & dosage. Middle Aged. Myeloma Proteins / metabolism. Prednisone / administration & dosage. Prospective Studies. Survival Analysis. Treatment Outcome

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  • (PMID = 15059138.001).
  • [ISSN] 0007-1048
  • [Journal-full-title] British journal of haematology
  • [ISO-abbreviation] Br. J. Haematol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase III; Journal Article; Multicenter Study
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Immunoglobulin A; 0 / Immunoglobulin G; 0 / Myeloma Proteins; 0 / multiple myeloma M-proteins; Q41OR9510P / Melphalan; VB0R961HZT / Prednisone
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20. Nakamura S, Yata K, Jinno T, Harada T, Fujii S, Miki H, Nakano A, Kagawa K, Takeuchi K, Ozaki S, Abe M, Matsumoto T: [Multiple myeloma complicated with disseminated zygomycosis after bortezomib therapy]. Rinsho Ketsueki; 2010 Aug;51(8):690-5
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  • [Title] [Multiple myeloma complicated with disseminated zygomycosis after bortezomib therapy].
  • A 67-year-old man was diagnosed with multiple myeloma IgA-lambda type, Durie-Salmon classification stage IIIA in October 2001.
  • He received five courses of induction chemotherapy consisting of vincristine, doxorubicin and dexamethasone and then underwent high dose chemotherapy followed by autologous stem cell transplantation in March 2003.
  • He achieved partial response, but then relapsed after treatment with thalidomide and was admitted to our hospital in June 2007.
  • The patient was complicated by tumor lysis syndrome (TLS) after receiving bortezomib therapy twice.
  • Computed tomography after bortezomib therapy showed the rapid appearance of tumors in the right upper lobe of the lung, tail of the pancreas and the spleen.
  • This case suggested that metabolic acidosis was caused by TLS, while poorly controlled diabetes, secondary hemochromatosis due to transfusion, and breakthrough zygomycosis during antifungal therapy were thought to be factors contributing to the development of zygomycosis.
  • [MeSH-major] Antineoplastic Agents / adverse effects. Antineoplastic Agents / therapeutic use. Boronic Acids / adverse effects. Boronic Acids / therapeutic use. Multiple Myeloma / complications. Multiple Myeloma / drug therapy. Pyrazines / adverse effects. Pyrazines / therapeutic use. Zygomycosis / etiology. Zygomycosis / pathology
  • [MeSH-minor] Acidosis / etiology. Aged. Antifungal Agents / adverse effects. Antifungal Agents / therapeutic use. Bortezomib. Echinocandins / adverse effects. Echinocandins / therapeutic use. Fatal Outcome. Humans. Lipopeptides / adverse effects. Lipopeptides / therapeutic use. Male. Pyrimidines / adverse effects. Pyrimidines / therapeutic use. Triazoles / adverse effects. Triazoles / therapeutic use. Tumor Lysis Syndrome / etiology. Voriconazole

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  • (PMID = 20805677.001).
  • [ISSN] 0485-1439
  • [Journal-full-title] [Rinshō ketsueki] The Japanese journal of clinical hematology
  • [ISO-abbreviation] Rinsho Ketsueki
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antifungal Agents; 0 / Antineoplastic Agents; 0 / Boronic Acids; 0 / Echinocandins; 0 / Lipopeptides; 0 / Pyrazines; 0 / Pyrimidines; 0 / Triazoles; 69G8BD63PP / Bortezomib; JFU09I87TR / Voriconazole; R10H71BSWG / micafungin
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21. Srkalovic G, Elson P, Trebisky B, Karam MA, Hussein MA: Use of melphalan, thalidomide, and dexamethasone in treatment of refractory and relapsed multiple myeloma. Med Oncol; 2002;19(4):219-26
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  • [Title] Use of melphalan, thalidomide, and dexamethasone in treatment of refractory and relapsed multiple myeloma.
  • Twenty-one patients with relapsed and refractory Durie-Salmon stage III multiple myeloma who had either failed at least three previous regimens or presented with poor performance status, neutropenia, or thrombocytopenia were treated with up to four cycles of combination melphalan (50 mg intravenously), thalidomide (titrated to target of 400 mg orally daily), and dexamethasone (40 mg/day orally on d 1 to 4) every 4-6 wk.
  • Maintenance treatment consisting of daily thalidomide and monthly dexamethasone was continued until disease progression.
  • Four patients died while on therapy: two from neutropenic complications and two from progressive disease.
  • These results show that melphalan/thalidomide/dexamethasone therapy is active and generally tolerated in heavily pretreated multiple myeloma patients whose prognosis is otherwise poor.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Multiple Myeloma / drug therapy

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  • [Cites] Blood. 2001 Jul 15;98(2):492-4 [11435324.001]
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  • (PMID = 12512915.001).
  • [ISSN] 1357-0560
  • [Journal-full-title] Medical oncology (Northwood, London, England)
  • [ISO-abbreviation] Med. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 4Z8R6ORS6L / Thalidomide; 7S5I7G3JQL / Dexamethasone; Q41OR9510P / Melphalan
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22. Arland M, Leuner S, Lange S, Bartsch R, Kahl C, Florschütz A, Franke A, Höffkes HG: Ifosamide, epirubicin and granulocyte colony-stimulating factor: a regimen for successful mobilization of peripheral blood progenitor cells in patients with multiple myeloma. Hematol Oncol; 2001 Jun;19(2):59-66
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  • [Title] Ifosamide, epirubicin and granulocyte colony-stimulating factor: a regimen for successful mobilization of peripheral blood progenitor cells in patients with multiple myeloma.
  • In general, the mobilization of peripheral blood progenitor cells (PBPC) in multiple myeloma (MM) patients is poor and is achieved in most cases by combined cyclophosphamide and G-CSF.
  • Sixteen patients suffering from multiple myeloma in stage II/A and III/A according to Durie and Salmon underwent chemotherapy consisting of a total of three cycles of ifosfamide (3 g/m(2) on days 1 and 2 and epirubicine 80 mg/m(2) on day 1) and G-CSF (10 or 20 microg/kg body weight (BW) daily until harvesting).
  • PBPC harvesting was performed after the first and third cycle of chemotherapy.
  • The median number of PBPC after the first cycle of chemotherapy was 7.79 x 10(6) CD34+ cells/kg BW (ranging from 0.94-26.36 x 10(6)) and 6.38 x 10(6) CD34+ cells/kg BW (ranging from 0.79-29.31 x 10(6)) after the third cycle of chemotherapy.
  • Clinical re-evaluation after three cycles of chemotherapy showed 13 (81 per cent) patients in partial remission (PR), two (12 per cent) in complete remission (CR) and one (6.25 per cent) in stable disease (SD).
  • No major side-effects were observed, six patients developed hematological toxicity stage IV WHO for a median of 3.9 days but no serious infection episodes occurred.
  • Combined ifosfamide/epirubicin and standard G-CSF is able to mobilize sufficient PBPC without serious side-effects for patients with MM and for purging procedures resulting in a high proportion of complete remissions after tandem high-dose melphalan chemotherapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Epirubicin / administration & dosage. Granulocyte Colony-Stimulating Factor / administration & dosage. Hematopoietic Stem Cell Mobilization / methods. Ifosfamide / administration & dosage. Multiple Myeloma / drug therapy
  • [MeSH-minor] Adult. Antibiotics, Antineoplastic / administration & dosage. Antibiotics, Antineoplastic / standards. Antibiotics, Antineoplastic / toxicity. Antineoplastic Agents, Alkylating / administration & dosage. Antineoplastic Agents, Alkylating / standards. Antineoplastic Agents, Alkylating / toxicity. Bone Marrow Purging / methods. Bone Marrow Purging / standards. Female. Humans. Leukopenia / chemically induced. Male. Middle Aged. Prospective Studies. Therapeutic Equivalency

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  • [Copyright] Copyright 2001 John Wiley & Sons, Ltd.
  • (PMID = 11438975.001).
  • [ISSN] 0278-0232
  • [Journal-full-title] Hematological oncology
  • [ISO-abbreviation] Hematol Oncol
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; 0 / Antineoplastic Agents, Alkylating; 143011-72-7 / Granulocyte Colony-Stimulating Factor; 3Z8479ZZ5X / Epirubicin; UM20QQM95Y / Ifosfamide
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23. Mose S, Pfitzner D, Rahn A, Nierhoff C, Schiemann M, Böttcher HD: [Role of radiotherapy in the treatment of multiple myeloma]. Strahlenther Onkol; 2000 Nov;176(11):506-12
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  • [Title] [Role of radiotherapy in the treatment of multiple myeloma].
  • [Transliterated title] Wertigkeit der Radiotherapie in der Behandlung des multiplen Myeloms.
  • BACKGROUND: Chemotherapy is the treatment of choice in multiple myeloma; but there are no curative options.
  • Therefore, the treatment rationale is characterized by reduction of symptoms and inhibition of complications.
  • Regarding reduction of pain, treatment of (impending) fractures, and spinal cord compression radiation is an important part of palliative treatment.
  • In our retrospective study we report the effect of radiotherapy on reduction of pain, recalcification and the reduction of neurological symptoms and evaluate factors which have an impact on therapeutic outcome.
  • PATIENTS AND METHODS: From 1, Jan 1988 to 31, Dec 1998, 42 patients (19 women, 23 men; range of ages 46 to 85 years, median age 64.9 years) with 71 target volumes were irradiated (median dose 36 Gy, 2 to 3 Gy 5 times/week) because of symptomatic disease (67/71: osseous pain, 45/71: fractures/impending fractures, 13/71: spinal cord compression) (Tables 1 and 2).
  • The median time from diagnosis to the first course of radiotherapy was 11.9 months (0.3 to 90 months).
  • At the time of first irradiation, 5 and 37 patients were in tumor Stage II and III (Salmon/Durie), respectively.
  • RESULTS: During follow-up (at least 6 months) in 85% of target volumes complete and partial pain relief (measured by patients' perception and the use of analgetic medication) was achieved; recurrences were seen in 8.8%.
  • In 22.3% of all lesions initially with impending fracture (4/18) radiotherapy failed because of fracture after treatment (Tables 3 and 4).
  • Simultaneous chemotherapy and a Karnofsky performance > or = 70 had a significant impact on a positive response to treatment, respectively.
  • CONCLUSION: When adequately indicated radiotherapy has shown to be an effective palliative treatment.
  • Taking under consideration that the results are retrospective we suppose that in multiple myeloma the local response to radiation is supported by a favorable performance status and simultaneous chemotherapy.
  • Irradiation treatment does not change prognosis regarding overall survival.
  • [MeSH-major] Multiple Myeloma / physiopathology. Multiple Myeloma / radiotherapy
  • [MeSH-minor] Aged. Aged, 80 and over. Female. Fractures, Bone / etiology. Humans. Male. Middle Aged. Neoplasm Staging. Pain. Palliative Care. Retrospective Studies. Spinal Cord Compression / radiotherapy. Survival Rate

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  • (PMID = 11143524.001).
  • [ISSN] 0179-7158
  • [Journal-full-title] Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]
  • [ISO-abbreviation] Strahlenther Onkol
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Germany
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24. Bakta IM, Sutarka IN: Biclonal gammopathy in multiple myeloma: a case report. Gan To Kagaku Ryoho; 2000 May;27 Suppl 2:544-8
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  • [Title] Biclonal gammopathy in multiple myeloma: a case report.
  • Monoclonal gammopathy is a group of B-cell disorders which result in the production of a specific and unique monoclonal immunoglobulin (M-component).
  • A blood smear showed the formation of rouleaux, but no plasma cells were found.
  • Plasma cells (myeloma cells) in bone marrow were 32%.
  • The clinical diagnosis was multiple myeloma (biclonal gammopathy) stage IIIB (Durie and Salmon staging system).
  • Clinical response was good after two series of conventional chemotherapy, with normal serum electrophoresis, decreasing serum creatinine and serum calcium.
  • Based on the above data, the diagnosis of multiple myeloma with biclonal gammopathy was confirmed.
  • [MeSH-major] Multiple Myeloma / complications. Myeloma Proteins / analysis. Paraproteinemias / etiology

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  • (PMID = 10895208.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] JAPAN
  • [Chemical-registry-number] 0 / Immunoglobulin A; 0 / Immunoglobulin M; 0 / Myeloma Proteins
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25. Myslivecek M, Nekula J, Bacovsky J, Scudla V, Koranda P, Kaminek M: Multiple myeloma: predictive value of Tc-99m MIBI scintigraphy and MRI in its diagnosis and therapy. Nucl Med Rev Cent East Eur; 2008;11(1):12-6
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  • [Title] Multiple myeloma: predictive value of Tc-99m MIBI scintigraphy and MRI in its diagnosis and therapy.
  • BACKGROUND: We assessed the validity of (99m)Tc-MIBI scintigraphy and MRI in the diagnosis and prediction of the effect of therapy in patients with multiple myeloma (MM) and monoclonal gammopathy of unknown significance (MGUS), in whom both examinations were performed within 14 days.
  • Out of 47 MM patients, 6 were in Durie-Salmon stage I and 41 had active disease in stage II or III.
  • Fifteen patients were examined before and within 2 months of intensive chemotherapy.
  • MRI of Th and LS spine, T1 w.i. and STIR in the sagittal plane were performed.
  • Out of 15 patients after therapy, 13 reached complete remission and 2 had stable disease.
  • The advantage of 99mTc-MIBI scintigraphy is the possibility of whole body examination, which allows superiority in detection of MM in appendicular skeleton and extramedular lesions, and faster response to therapy, while the advantage of MRI is the detection of epidural masses and vertebral compressions influencing the therapeutic strategy.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Magnetic Resonance Imaging / methods. Multiple Myeloma / diagnosis. Multiple Myeloma / drug therapy. Technetium Tc 99m Sestamibi
  • [MeSH-minor] Female. Humans. Male. Middle Aged. Prognosis. Radiopharmaceuticals. Reproducibility of Results. Sensitivity and Specificity. Treatment Outcome

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  • (PMID = 19173182.001).
  • [ISSN] 1506-9680
  • [Journal-full-title] Nuclear medicine review. Central & Eastern Europe
  • [ISO-abbreviation] Nucl Med Rev Cent East Eur
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Poland
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Radiopharmaceuticals; 971Z4W1S09 / Technetium Tc 99m Sestamibi
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26. Szelényi H, Kreuser ED, Keilholz U, Menssen HD, Keitel-Wittig C, Siehl J, Knauf W, Thiel E: Cyclophosphamide, adriamycin and dexamethasone (CAD) is a highly effective therapy for patients with advanced multiple myeloma. Ann Oncol; 2001 Jan;12(1):105-8
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  • [Title] Cyclophosphamide, adriamycin and dexamethasone (CAD) is a highly effective therapy for patients with advanced multiple myeloma.
  • BACKGROUND: Patients with advanced multiple myeloma (stage III or progressive myeloma) received the CAD protocol every three weeks: cyclophosphamide 200 mg/m2 i.v.
  • According to Durie-Salmon 44 patients were in stage III, 2 in stage II; 6 patients had renal insufficiency (stage B).
  • After an observation time of 14 months the median progression free interval for 33 patients not treated with subsequent high-dose chemotherapy with stem-cell support was more than 14 months.
  • Overall, treatment was well tolerated.

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  • (PMID = 11249035.001).
  • [ISSN] 0923-7534
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 7S5I7G3JQL / Dexamethasone; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide
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27. Schaapveld M, Visser O, Siesling S, Schaar CG, Zweegman S, Vellenga E: Improved survival among younger but not among older patients with Multiple Myeloma in the Netherlands, a population-based study since 1989. Eur J Cancer; 2010 Jan;46(1):160-9
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  • [Title] Improved survival among younger but not among older patients with Multiple Myeloma in the Netherlands, a population-based study since 1989.
  • This study assesses whether new treatment strategies developed in clinical trials translate into improved survival for multiple myeloma (MM) patients in the Netherlands.
  • The effect of period of diagnosis (1989-1992, 1993-1996, 1997-2000, 2001-2005), age (<50, 50-65, 66-74, 75), gender, Salmon-Durie (SD) stage, trial participation and treatment on relative survival were studied.
  • When trial participation was analysed for exact periods in which trials were open, 16% of patients aged 65 years with SD-stage I and 38% with SD-stage II or III were enrolled compared to 2% of patients aged >65 years with SD-stage I and 5% with SD-stage II or III.
  • Relative survival decreased with age (p<.001), with advanced stage (p<.001) and was better for patients enrolled in trials (p<.001).
  • The excess mortality was 37% lower in 2001-2005 than in 1989-1992 for these patients, adjusted for age, stage, trial participation and gender (p<.001).
  • The improved survival of younger patients coincided with increasing trial participation and increasing use of high-dose chemotherapy and autologous stem-cell transplantation.
  • [MeSH-major] Multiple Myeloma / mortality
  • [MeSH-minor] Adolescent. Adult. Age Distribution. Age Factors. Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Epidemiologic Methods. Female. Humans. Male. Middle Aged. Mortality / trends. Neoplasm Staging. Netherlands / epidemiology. Prognosis. Young Adult

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  • (PMID = 19682891.001).
  • [ISSN] 1879-0852
  • [Journal-full-title] European journal of cancer (Oxford, England : 1990)
  • [ISO-abbreviation] Eur. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] England
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28. Nozza A, Siracusano L, Armando S: Bortezomib-dexamethasone combination in a patient with refractory multiple myeloma and impaired renal function. Clin Ther; 2006 Jun;28(6):953-9
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  • [Title] Bortezomib-dexamethasone combination in a patient with refractory multiple myeloma and impaired renal function.
  • BACKGROUND: Multiple myeloma (MM) is a hematologic neoplasia characterized by the monoclonal proliferation of bone marrow plasma cells.
  • For those with advanced MM, often a high-risk group of patients with poor prognosis, salvage treatment for renal failure needs to avoid nephrotoxic drugs.
  • CASE SUMMARY: We report a case of a 78-year-old white male (weight, 90 kg) presented to the Department of Medical Oncology and Hematology, Istituto Clinico Humanitas, Rozzano, Milan, Italy, with refractory MM immunoglobulin G kappa (IgGkappa), Durie-Salmon Stage IIA, with progressive renal failure after an oral melphalan, prednisone, and thalidomide regimen (4 mg/m2.d, 40 mg/m2.d for 7 days every 6 weeks, and 100 mg/d, respectively).
  • The patient developed thrombocytopenia but did not suffer from some of the more severe adverse events associated with bortezomib, such as infection or peripheral neuropathy, even at full dose.
  • CONCLUSION: We report an elderly patient with refractory MM and progression with renal failure who responded to bortezomib treatment.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Multiple Myeloma / drug therapy. Renal Insufficiency / complications

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  • (PMID = 16860177.001).
  • [ISSN] 0149-2918
  • [Journal-full-title] Clinical therapeutics
  • [ISO-abbreviation] Clin Ther
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Boronic Acids; 0 / Pyrazines; 69G8BD63PP / Bortezomib; 7S5I7G3JQL / Dexamethasone
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29. Cook G, Clark RE, Morris TC, Robertson M, Lucie NP, Anderson S, Paul J, Franklin IM: A randomized study (WOS MM1) comparing the oral regime Z-Dex (idarubicin and dexamethasone) with vincristine, adriamycin and dexamethasone as induction therapy for newly diagnosed patients with multiple myeloma. Br J Haematol; 2004 Sep;126(6):792-8
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  • [Title] A randomized study (WOS MM1) comparing the oral regime Z-Dex (idarubicin and dexamethasone) with vincristine, adriamycin and dexamethasone as induction therapy for newly diagnosed patients with multiple myeloma.
  • Whilst infusional vincristine, adriamycin and dexamethasone (VAD) is an effective treatment for patients with multiple myeloma (MM), administration may be complicated by line-associated infections and thromboses.
  • We conducted a randomized study comparing Z-Dex with VAD as induction therapy in newly diagnosed MM patients.
  • A total of 106 patients (median age, 56 years; range: 37-73; Durie-Salmon stage II/III) were randomized to receive four to six cycles of Z-Dex or VAD.
  • Neutropenia (all grades) was more common in the Z-Dex arm (P = 0.009) although grade III/IV neutropenia was not significantly different between the treatment groups (P = 0.06).
  • The responses to therapy (complete/partial response) in evaluable patients were: VAD 74% vs. Z-Dex 58%, with an estimated difference in response of 16% (95% CI -2-33, P = 0.075).
  • VAD recipients (15%) suffered early treatment-related mortality compared with 12% of Z-Dex recipients.
  • This study demonstrated that Z-Dex might be a suitable oral alternative to VAD for treating newly diagnosed MM patients, although definitive evidence for equivalence is not provided.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Multiple Myeloma / drug therapy
  • [MeSH-minor] Adult. Aged. Dexamethasone / administration & dosage. Dexamethasone / adverse effects. Disease-Free Survival. Doxorubicin / administration & dosage. Doxorubicin / adverse effects. Female. Humans. Idarubicin / administration & dosage. Idarubicin / adverse effects. Male. Middle Aged. Survival Rate. Treatment Outcome. Vincristine / administration & dosage. Vincristine / adverse effects

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  • (PMID = 15352982.001).
  • [ISSN] 0007-1048
  • [Journal-full-title] British journal of haematology
  • [ISO-abbreviation] Br. J. Haematol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase III; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 5J49Q6B70F / Vincristine; 7S5I7G3JQL / Dexamethasone; 80168379AG / Doxorubicin; ZRP63D75JW / Idarubicin; VAD protocol
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30. Berenson JR: Bone disease in myeloma. Curr Treat Options Oncol; 2001 Jun;2(3):271-83
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  • [Title] Bone disease in myeloma.
  • The major clinical manifestation of multiple myeloma results from osteolytic bone destruction.
  • The only currently Food and Drug Administration-approved drug for the treatment of the bony complications of multiple myeloma is monthly intravenous pamidronate at a dose of 90 mg infused over 4 hours.
  • Although the duration of therapy has not been firmly determined, it is likely that discontinuation of this drug will be met by enhanced bone loss and an increased risk of bony complications for these patients.
  • Thus, it is recommended that the drug be continued indefinitely.
  • Support for this recommendation also comes from the reduced bone density observed in women with postmenopausal osteoporosis following the withdrawal of bisphosphonate treatment.
  • Importantly, the drug can be safely administered at 90 mg monthly to patients with poor renal function.
  • The use of pamidronate for myeloma patients without lytic bone involvement or with Durie-Salmon stages I or II disease has not been evaluated.
  • The potential antimyeloma effect of this agent is another reason to administer this drug in these types of patients.
  • Thus, it is our practice to administer monthly pamidronate to myeloma patients regardless of stage or bone involvement.
  • However, trials evaluating oral bisphosphonates have produced inconsistent clinical results, probably as a result of the erratic and scanty poor absorption as well as poor oral tolerability of these drugs.
  • Although these oral agents may be useful in some patients, it is impossible to identify which myeloma patients will benefit from orally administered bisphosphonates.
  • Many other types of new agents are in early clinical trials, but their efficacy remains unproven at the present time.
  • [MeSH-major] Bone Diseases / therapy. Multiple Myeloma / therapy
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Diphosphonates / therapeutic use. Humans. Radiotherapy

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  • (PMID = 12057127.001).
  • [ISSN] 1527-2729
  • [Journal-full-title] Current treatment options in oncology
  • [ISO-abbreviation] Curr Treat Options Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Diphosphonates
  • [Number-of-references] 75
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31. Xu L, Wang Y, Wu W, Yan H, Gao XD, Yu Q, Shen ZX, Mi JQ: [Clinical study of multiple myeloma: a report of 182 cases]. Zhonghua Yi Xue Za Zhi; 2010 Apr 13;90(14):972-7
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  • [Title] [Clinical study of multiple myeloma: a report of 182 cases].
  • OBJECTIVE: To explore the applicability of Durie Salmon (DS) and International Staging System (ISS) for Chinese patients with multiple myeloma (MM) and to evaluate the efficacy of major therapeutic options and the influence of various prognostic factors on survival were also evaluated.
  • METHODS: The patient survival was compared with regards to DS and ISS.
  • RESULTS: The median survival of patients with DS stages I, II and III were 79, 82 and 43 months, respectively.
  • There was no significance between stage I and II/III.
  • Multivariate analysis suggested that age, percentage of plasma cell in bone marrow, C-reactive protein (CRP) and beta2-microglobulin (2-MG) were independent prognostic factors for OS.
  • CONCLUSION: ISS is more applicable than DS, especially for low risk patients.
  • The efficacy of VAD-like regimen combined Thal as first-line treatment is proven to be reliable.
  • Induction therapy including thalidomide can not only improve the ORR, but also delay the relapse or progression of disease.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols. Multiple Myeloma / drug therapy. Multiple Myeloma / pathology
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Dexamethasone. Doxorubicin. Female. Humans. Male. Middle Aged. Neoplasm Staging. Prognosis. Thalidomide / therapeutic use. Treatment Outcome. Vincristine. Young Adult

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  • (PMID = 20646647.001).
  • [ISSN] 0376-2491
  • [Journal-full-title] Zhonghua yi xue za zhi
  • [ISO-abbreviation] Zhonghua Yi Xue Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Evaluation Studies; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 4Z8R6ORS6L / Thalidomide; 5J49Q6B70F / Vincristine; 7S5I7G3JQL / Dexamethasone; 80168379AG / Doxorubicin; VAD I protocol
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32. Hassoun H, Reich L, Klimek VM, Dhodapkar M, Cohen A, Kewalramani T, Zimman R, Drake L, Riedel ER, Hedvat CV, Teruya-Feldstein J, Filippa DA, Fleisher M, Nimer SD, Comenzo RL: Doxorubicin and dexamethasone followed by thalidomide and dexamethasone is an effective well tolerated initial therapy for multiple myeloma. Br J Haematol; 2006 Jan;132(2):155-61
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  • [Title] Doxorubicin and dexamethasone followed by thalidomide and dexamethasone is an effective well tolerated initial therapy for multiple myeloma.
  • Among the drug combinations designed for the initial treatment of multiple myeloma, none has been unequivocally shown to be superior.
  • We report the results of a phase II clinical trial involving 45 patients with Durie-Salmon stage II and III multiple myeloma.
  • Among the 42 patients whose response could be assessed, 38 responded to therapy (90.5%).
  • Normalization of the free light chain ratio after one or two cycles of treatment was highly predictive of achievement of CR or nCR.
  • Patients tolerated the treatment well although five patients developed thromboembolic complications (11%).
  • AD-TD administered with low dose aspirin for deep vein thrombosis prophylaxis was well tolerated and yielded a high response rate with minimal treatment-related morbidity.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Multiple Myeloma / drug therapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Dexamethasone / administration & dosage. Dexamethasone / adverse effects. Doxorubicin / administration & dosage. Doxorubicin / adverse effects. Drug Administration Schedule. Female. Hematopoietic Stem Cell Mobilization. Humans. Male. Middle Aged. Thalidomide / administration & dosage. Thalidomide / adverse effects. Treatment Outcome

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  • [CommentIn] Br J Haematol. 2006 Apr;133(2):216 [16611319.001]
  • (PMID = 16398649.001).
  • [ISSN] 0007-1048
  • [Journal-full-title] British journal of haematology
  • [ISO-abbreviation] Br. J. Haematol.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA05826
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.
  • [Publication-country] England
  • [Chemical-registry-number] 4Z8R6ORS6L / Thalidomide; 7S5I7G3JQL / Dexamethasone; 80168379AG / Doxorubicin
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33. Sezer O, Jakob C, Eucker J, Niemöller K, Gatz F, Wernecke K, Possinger K: Serum levels of the angiogenic cytokines basic fibroblast growth factor (bFGF), vascular endothelial growth factor (VEGF) and hepatocyte growth factor (HGF) in multiple myeloma. Eur J Haematol; 2001 Feb;66(2):83-8
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  • [Title] Serum levels of the angiogenic cytokines basic fibroblast growth factor (bFGF), vascular endothelial growth factor (VEGF) and hepatocyte growth factor (HGF) in multiple myeloma.
  • Since an increased angiogenic potential has been identified in multiple myeloma, we simultaneously measured circulating serum levels of the cytokines bFGF, VEGF, HGF and IL-6 by ELISA in 67 patients with multiple myeloma or monoclonal gammopathies of undetermined significance (MGUS) and in 20 controls.
  • Median values of bFGF were 4.7 pg/ml in healthy volunteers, 6.2 in MGUS, 6.3 in myeloma stage I, 13.4 in stage II and 21.7 in stage III.
  • Myeloma patients had significantly higher bFGF serum levels than controls (p<0.001).
  • Pretreatment bFGF levels differed significantly in the Salmon and Durie stages I-III (p=0.02) and were significantly elevated in stage II-III compared to stage I myeloma (p=0.02).
  • In patients responding to chemotherapy according to the CLMTF criteria, a significant decrease in serum bFGF, VEGF and HGF levels occurred (median pretreatment values for bFGF 23.9 pg/ml, post-treatment 6.5 pg/ml; p<0.001, for VEGF 223 pg/ml versus 105 pg/ml; p=0.02 and for HGF 1429 pg/ml versus 1077 pg/ml; p=0.02, respectively).
  • These data show that myeloma in stages II and III is associated with an increase in serum bFGF concentrations and give the first report that effective chemo-therapy is accompanied by a significant decrease in the angiogenic factors bFGF, VEGF and HGF, while no decrease of these factors could be found in nonresponders.
  • [MeSH-major] Growth Substances / blood. Multiple Myeloma / blood
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Antineoplastic Agents / pharmacology. Endothelial Growth Factors / blood. Fibroblast Growth Factor 2 / blood. Hepatocyte Growth Factor / blood. Humans. Interleukin-6 / blood. Lymphokines / blood. Middle Aged. Neoplasm Staging. Neovascularization, Pathologic / blood. Paraproteinemias / blood. Statistics, Nonparametric. Vascular Endothelial Growth Factor A. Vascular Endothelial Growth Factors

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  • (PMID = 11168514.001).
  • [ISSN] 0902-4441
  • [Journal-full-title] European journal of haematology
  • [ISO-abbreviation] Eur. J. Haematol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Denmark
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Endothelial Growth Factors; 0 / Growth Substances; 0 / Interleukin-6; 0 / Lymphokines; 0 / Vascular Endothelial Growth Factor A; 0 / Vascular Endothelial Growth Factors; 103107-01-3 / Fibroblast Growth Factor 2; 67256-21-7 / Hepatocyte Growth Factor
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34. Rajkumar SV, Fonseca R, Dispenzieri A, Lacy MQ, Lust JA, Witzig TE, Kyle RA, Gertz MA, Greipp PR: Thalidomide in the treatment of relapsed multiple myeloma. Mayo Clin Proc; 2000 Sep;75(9):897-901
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  • [Title] Thalidomide in the treatment of relapsed multiple myeloma.
  • OBJECTIVE: To describe the efficacy of therapy with thalidomide, a drug that has antiangiogenic properties, in patients with relapsed multiple myeloma.
  • PATIENTS AND METHODS: We studied 16 patients (median age, 64 years) who received thalidomide for relapsed myeloma at the Mayo Clinic in Rochester, Minn, between November 1998 and August 1999.
  • Treatment consisted of thalidomide given orally at a dose of 200 mg/d for 2 weeks, then increased by 200 mg/d every 2 weeks, up to a maximal dose of 800 mg/d.
  • RESULTS: The stage of myeloma at treatment was Durie-Salmon IIIA in 9 patients (56%) and IIIB in 7 (44%).
  • The median time from myeloma diagnosis to initiation of thalidomide therapy was 32 months.
  • In 4 patients (25%) prior stem cell transplantation had failed, and 14 (88%) had received 2 or more prior chemotherapeutic regimens before institution of thalidomide.
  • Four (25%) achieved a partial response to therapy, with a greater than 50% reduction in the serum or urine M protein level.
  • CONCLUSION: Thalidomide is an active agent in the treatment of patients with advanced myeloma.
  • [MeSH-major] Angiogenesis Inhibitors / therapeutic use. Multiple Myeloma / drug therapy. Muscle Proteins. Thalidomide / therapeutic use
  • [MeSH-minor] Administration, Oral. Aged. Aged, 80 and over. Connectin. Disease-Free Survival. Female. Follow-Up Studies. Hematopoietic Stem Cell Transplantation. Humans. Male. Middle Aged. Myeloma Proteins / urine. Recurrence. Severity of Illness Index. Treatment Failure

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  • (PMID = 10994824.001).
  • [ISSN] 0025-6196
  • [Journal-full-title] Mayo Clinic proceedings
  • [ISO-abbreviation] Mayo Clin. Proc.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA62242; United States / NCI NIH HHS / CA / CA85818
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Angiogenesis Inhibitors; 0 / Connectin; 0 / Muscle Proteins; 0 / Myeloma Proteins; 0 / multiple myeloma M-proteins; 4Z8R6ORS6L / Thalidomide
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35. Jánosi J, Sebestyén A, Mikala G, Petö M, Jákó J, Domján G, Németh J, Kis Z, Kopper L, Vályi-Nagy I: [Soluble syndecan-1 levels in different plasma cell dyscrasias]. Orv Hetil; 2005 Jan 23;146(4):165-8
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  • [Title] [Soluble syndecan-1 levels in different plasma cell dyscrasias].
  • INTRODUCTION: Syndecans are a family of cell surface proteoglycans.
  • In the bone marrow of multiple myeloma patients syndecan-1 is expressed only on the surface of malignant plasma cells.
  • The aim of the study was to determine the soluble syndecan-1 levels in different plasma cell dyscrasias.
  • RESULTS: Patients with multiple myeloma showed a significantly higher median serum syndecan-1 level than patients with plasmocytoma or monoclonal gammopathy of undetermined significance.
  • Statistically significant differences were also observed among Salmon-Durie subgroups of 50 patients suffering from multiple myeloma.
  • In addition to these findings a statistical correlation with other independent prognostic factors such as serum beta2-microglobulin level, monoclonal immunoglobulin concentration, and bone marrow plasma cell count could also be noted.
  • A significant decrease in median serum syndecan level was observed in patients who responded to chemotherapy, whereas no change in the median syndecan-1 level could be observed in nonresponders.
  • CONCLUSION: These findings confirm the observation that high serum soluble syndecan-1 level is associated with a more advanced disease stage and is a strong independent indicator of poor prognosis.
  • A diminished serum syndecan-1 reading as a result of chemotherapy may be a good indicator of favorable response to antitumor treatment.
  • [MeSH-major] Membrane Glycoproteins / blood. Multiple Myeloma / blood. Paraproteinemias / blood. Plasmacytoma / blood. Proteoglycans / blood

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  • (PMID = 15751511.001).
  • [ISSN] 0030-6002
  • [Journal-full-title] Orvosi hetilap
  • [ISO-abbreviation] Orv Hetil
  • [Language] hun
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Hungary
  • [Chemical-registry-number] 0 / Membrane Glycoproteins; 0 / Proteoglycans; 0 / SDC1 protein, human; 0 / Syndecan-1; 0 / Syndecans
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36. Broyl A, Corthals SL, Jongen JL, van der Holt B, Kuiper R, de Knegt Y, van Duin M, el Jarari L, Bertsch U, Lokhorst HM, Durie BG, Goldschmidt H, Sonneveld P: Mechanisms of peripheral neuropathy associated with bortezomib and vincristine in patients with newly diagnosed multiple myeloma: a prospective analysis of data from the HOVON-65/GMMG-HD4 trial. Lancet Oncol; 2010 Nov;11(11):1057-65
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  • [Title] Mechanisms of peripheral neuropathy associated with bortezomib and vincristine in patients with newly diagnosed multiple myeloma: a prospective analysis of data from the HOVON-65/GMMG-HD4 trial.
  • BACKGROUND: Bortezomib-induced peripheral neuropathy is a dose-limiting toxicity in patients with multiple myeloma, often requiring adjustment of treatment and affecting quality of life.
  • We investigated the molecular profiles of early-onset (within one treatment cycle) versus late-onset (after two or three treatment cycles) bortezomib-induced peripheral neuropathy and compared them with those of vincristine-induced peripheral neuropathy during the induction phase of a prospective phase 3 trial.
  • METHODS: In the induction phase of the HOVON-65/GMMG-HD4 trial, patients (aged 18-65 years) with newly diagnosed Salmon and Durie stage 2 or 3 multiple myeloma were randomly assigned to three cycles of bortezomib-based or vincristine-based induction treatment.
  • We analysed the gene expression profiles and single-nucleotide polymorphisms (SNPs) of pretreatment samples of myeloma plasma cells and peripheral blood, respectively.
  • FINDINGS: We analysed gene expression profiles of myeloma plasma cells from 329 (39%) of 833 patients at diagnosis, and SNPs in DNA samples from 369 (44%) patients.
  • Early-onset bortezomib-induced peripheral neuropathy was noted in 20 (8%) patients, and 63 (25%) developed the late-onset type.
  • Significant genes in myeloma plasma cells from patients that were associated with early-onset bortezomib-induced peripheral neuropathy were the enzyme coding genes RHOBTB2 (upregulated by 1·59 times; p=4·5×10(-5)), involved in drug-induced apoptosis, CPT1C (1·44 times; p=2·9×10(-7)), involved in mitochondrial dysfunction, and SOX8 (1·68 times; p=4·28×10(-13)), involved in development of peripheral nervous system.
  • In late-onset bortezomib-induced peripheral neuropathy, the significant genes were SOD2 (upregulated by 1·18 times; p=9·6×10(-3)) and MYO5A (1·93 times; p=3·2×10(-2)), involved in development and function of the nervous system.
  • By contrast, early-onset vincristine-induced peripheral neuropathy was characterised by upregulation of genes involved in cell cycle and proliferation, including AURKA (3·31 times; p=1·04×10(-2)) and MKI67 (3·66 times; p=1·82×10(-3)), and the presence of SNPs in genes involved in these processes-eg, GLI1 (rs2228224 [0·13, 0·02-0·97, p=1·18×10(-2)] and rs2242578 [0·14, 0·02-1·12, p=3·00×10(-2)]).
  • INTERPRETATION: Our results strongly suggest an interaction between myeloma-related factors and the patient's genetic background in the development of treatment-induced peripheral neuropathy, with different molecular pathways being implicated in bortezomib-induced and vincristine-induced peripheral neuropathy.
  • [MeSH-major] Antineoplastic Agents / adverse effects. Boronic Acids / adverse effects. Multiple Myeloma / drug therapy. Peripheral Nervous System Diseases / chemically induced. Pyrazines / adverse effects. Vincristine / adverse effects
  • [MeSH-minor] Adolescent. Adult. Aged. Bortezomib. Chi-Square Distribution. Europe. Gene Expression Profiling. Gene Frequency. Genetic Predisposition to Disease. Humans. Middle Aged. Neoplasm Staging. Odds Ratio. Polymorphism, Single Nucleotide. Prospective Studies. Risk Assessment. Risk Factors. Time Factors. Treatment Outcome. Young Adult


37. Ludwig H, Zojer N: Renal recovery with lenalidomide in a patient with bortezomib-resistant multiple myeloma. Nat Rev Clin Oncol; 2010 May;7(5):289-94
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  • [Title] Renal recovery with lenalidomide in a patient with bortezomib-resistant multiple myeloma.
  • DIAGNOSIS: Durie-Salmon stage IIIB multiple myeloma with IgG lambda gammopathy and renal impairment associated with urinary excretion of free lambda light chains.
  • A standard regimen of bortezomib, doxorubicin and dexamethasone was started, but the patient did not respond and developed severe renal failure.
  • Treatment was switched to low-dose lenalidomide and high-dose dexamethasone.
  • Therapy was well tolerated, and the patient underwent autologous stem-cell transplantation around 16 months after start of induction treatment and 12 months after the start of lenalidomide-based therapy.
  • At 2 years after initiation of lenalidomide-based therapy, the patient remains in partial remission with stable renal function and excellent performance status.
  • [MeSH-major] Multiple Myeloma
  • [MeSH-minor] Antibiotics, Antineoplastic / administration & dosage. Antineoplastic Agents / administration & dosage. Antineoplastic Agents, Hormonal / administration & dosage. Boronic Acids. Bortezomib. Dexamethasone / administration & dosage. Doxorubicin / administration & dosage. Follow-Up Studies. Hematopoietic Stem Cell Transplantation. Humans. Kidney / pathology. Male. Middle Aged. Pyrazines. Remission Induction. Renal Insufficiency / complications. Renal Insufficiency / drug therapy. Renal Insufficiency / etiology. Thalidomide / analogs & derivatives. Time Factors. Treatment Outcome. X-Rays

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  • [CommentIn] Nat Rev Clin Oncol. 2010 Sep;7(9). doi: 10.1038/nrclinonc.2010.31-c1; author reply doi:10.1038/nrclinonc.2010.31-c3 [20824906.001]
  • [CommentIn] Nat Rev Clin Oncol. 2010 Sep;7(9). doi: 10.1038/nrclinonc.2010.31-c2; author reply doi:10.1038/nrclinonc.2010.31-c3 [20824907.001]
  • (PMID = 20351701.001).
  • [ISSN] 1759-4782
  • [Journal-full-title] Nature reviews. Clinical oncology
  • [ISO-abbreviation] Nat Rev Clin Oncol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; 0 / Antineoplastic Agents; 0 / Antineoplastic Agents, Hormonal; 0 / Boronic Acids; 0 / Pyrazines; 4Z8R6ORS6L / Thalidomide; 69G8BD63PP / Bortezomib; 7S5I7G3JQL / Dexamethasone; 80168379AG / Doxorubicin; F0P408N6V4 / lenalidomide
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38. Cem Ar M, Soysal T, Hatemi G, Salihoglu A, Yazici H, Ulku B: Successful management of cryoglobulinemia-induced leukocytoclastic vasculitis with thalidomide in a patient with multiple myeloma. Ann Hematol; 2005 Sep;84(9):609-13
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  • [Title] Successful management of cryoglobulinemia-induced leukocytoclastic vasculitis with thalidomide in a patient with multiple myeloma.
  • It is characterised by segmental angiocentric neutrophilic inflammation, endothelial cell damage and fibrinoid necrosis.
  • LV is related to a variety of clinical disorders including cryoglobulinemia and, very rarely, multiple myeloma (MM), among many others.
  • The development of LV in patients with MM has been linked to cryoglobulinemia, infections, drugs and paraneoplasia.
  • It has been speculated that myeloma patients with a poorer prognosis and progressive disease are more prone to develop LV.
  • Thalidomide is a rediscovered old drug with anti-angiogenic, immunomodulatory and anti-inflammatory properties.
  • It is highly effective in the treatment of MM and other clinical disorders such as leprosy, various cancers, graft-versus-host disease and autoimmune diseases.
  • We report here a female patient with Durie-Salmon stage IIA MM who initially presented with cryoglobulinemia and LV.
  • [MeSH-major] Cryoglobulinemia / complications. Multiple Myeloma / complications. Thalidomide / therapeutic use. Vasculitis, Leukocytoclastic, Cutaneous / drug therapy
  • [MeSH-minor] Dexamethasone / therapeutic use. Disease Management. Drug Therapy, Combination. Female. Humans. Middle Aged. Remission Induction


39. Urbańska-Ryś H, Robak T: High serum level of endostatin in multiple myeloma at diagnosis but not in the plateau phase after treatment. Mediators Inflamm; 2003 Aug;12(4):229-35
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  • [Title] High serum level of endostatin in multiple myeloma at diagnosis but not in the plateau phase after treatment.
  • We investigated the serum concentration of endostatin in 84 patients with multiple myeloma (MM) and in 13 healthy controls.
  • The level of measured anti-angiogenic agent was correlated with the phase and stage of the disease, and most importantly with clinical and laboratory parameters depicting the disease activity (haemoglobin, creatinine, albumins, calcium, M-component, C-reactive protein, beta2-microglobulin, lactate dehydrogenase, stage of bone disease) as well as serum levels of pro-angiogenic cytokines such as vascular endothelial growth factor, hepatocyte growth factor, fibroblast growth factor and transforming growth factor-beta.
  • MM patients in phase I (at diagnosis) had higher levels of endostatin (median, 69 ng/ml) than those in phase II (plateau phase after treatment) (median, 49 pg/ml; p=0.044).
  • We did not find any statistical correlation between the level of endostatin and stage of MM according to the Durie and Salmon system.
  • We did not show any statistical correlation between the concentration of endostatin and level of haemoglobin, creatinine, calcium, C-reactive protein, beta2-microglobulin and stage of bone disease.
  • [MeSH-major] Angiogenesis Inhibitors / blood. Antineoplastic Agents / therapeutic use. Endostatins / blood. Multiple Myeloma / blood. Multiple Myeloma / drug therapy

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  • (PMID = 14514474.001).
  • [ISSN] 0962-9351
  • [Journal-full-title] Mediators of inflammation
  • [ISO-abbreviation] Mediators Inflamm.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Angiogenesis Inhibitors; 0 / Antineoplastic Agents; 0 / Endostatins; 0 / Growth Substances
  • [Other-IDs] NLM/ PMC1781619
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40. Michopoulos S, Petraki K, Petraki C, Dimopoulos MA: Light chain deposition disease of the liver without renal involvement in a patient with multiple myeloma related to liver failure and rapid fatal outcome. Dig Dis Sci; 2002 Apr;47(4):730-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Light chain deposition disease of the liver without renal involvement in a patient with multiple myeloma related to liver failure and rapid fatal outcome.
  • We describe a 36-year-old man with advanced multiple myeloma (Salmon and Durie stage III) who developed jaundice and severe cholestasis after a first cure with systemic chemotherapy of vincristine, doxorubicin, and oral dexamethasone (VAD).
  • The patient developed rapid deterioration of liver function, leading to a multisystem dysfunction and death.
  • The occurrence of LCDD in multiple myeloma is close to 5% and myeloma is the underlying disease in two thirds of patients with LCDD.
  • This is the first observation of LCDD presenting with jaundice and severe cholestasis shortly after the diagnosis of high tumor mass myeloma, without overt renal involvement, leading rapidly to the patient's death.
  • [MeSH-major] Immunoglobulin Light Chains / metabolism. Liver Diseases / complications. Liver Diseases / metabolism. Liver Failure / etiology. Multiple Myeloma / complications
  • [MeSH-minor] Adult. Fatal Outcome. Humans. Liver / metabolism. Liver / pathology. Male. Time Factors


41. Rosen LS, Gordon D, Kaminski M, Howell A, Belch A, Mackey J, Apffelstaedt J, Hussein M, Coleman RE, Reitsma DJ, Seaman JJ, Chen BL, Ambros Y: Zoledronic acid versus pamidronate in the treatment of skeletal metastases in patients with breast cancer or osteolytic lesions of multiple myeloma: a phase III, double-blind, comparative trial. Cancer J; 2001 Sep-Oct;7(5):377-87
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  • [Title] Zoledronic acid versus pamidronate in the treatment of skeletal metastases in patients with breast cancer or osteolytic lesions of multiple myeloma: a phase III, double-blind, comparative trial.
  • PURPOSE: Zoledronic acid, a new and more potent bisphosphonate, was compared with pamidronate, the current standard treatment for patients with osteolytic or mixed bone metastases/lesions.
  • PATIENTS AND METHODS: A total of 1,648 patients with either Durie-Salmon stage III multiple myeloma or advanced breast cancer and at least one bone lesion were randomly assigned to treatment with either 4 or 8 mg of zoledronic acid via 15-minute intravenous infusion or 90 mg of pamidronate via 2-hour intravenous infusion every 3 to 4 weeks for 12 months.
  • RESULTS: The proportion of patients with at least one skeletal-related event was similar in all treatment groups.
  • Median time to the first skeletal-related eventwas approximately 1 year in each treatment group.
  • The skeletal morbidity rate was slightly lower in patients treated with zoledronic acid than in those treated with pamidronate, and zoledronic acid (4 mg) significantly decreased the incidence and event rate for radiation therapy to bone, both overall and in breast cancer patients receiving hormonal therapy.
  • Pain scores decreased in all treatment groups in the presence of stable or decreased analgesic use.
  • Zoledronic acid (4 mg) and pamidronate were equally well tolerated; the most common adverse events were bone pain, nausea, fatigue, and fever and < 5% of serious adverse events were related to the study drug.
  • CONCLUSIONS: Zoledronic acid (4 mg) via 15-minute intravenous infusion was as effective and well tolerated as 90 mg of pamidronate in the treatment of osteolytic and mixed bone metastases/lesions in patients with advanced breast cancer or multiple myeloma. (Can-
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Bone Neoplasms / drug therapy. Bone Neoplasms / secondary. Breast Neoplasms / pathology. Diphosphonates / therapeutic use. Imidazoles / therapeutic use. Multiple Myeloma / pathology


42. Palumbo A, Bringhen S, Bertola A, Cavallo F, Falco P, Massaia M, Bruno B, Rus C, Barbui A, Caravita T, Musto P, Pescosta N, Rossini F, Vignetti M, Boccadoro M: Multiple myeloma: comparison of two dose-intensive melphalan regimens (100 vs 200 mg/m(2)). Leukemia; 2004 Jan;18(1):133-8
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  • [Title] Multiple myeloma: comparison of two dose-intensive melphalan regimens (100 vs 200 mg/m(2)).
  • Several trials have shown the superior impact of high-dose melphalan (usually 200 mg/m(2), MEL200) vs standard therapy in myeloma patients.
  • Their clinical outcome was compared with that of a control group of 90 pair mates matched for serum beta2-microglobulin levels and Durie and Salmon clinical stage.
  • The intensified nonmyeloablative MEL100 regimen is an effective first-line treatment.
  • [MeSH-major] Antineoplastic Agents, Alkylating / administration & dosage. Melphalan / administration & dosage. Multiple Myeloma / drug therapy
  • [MeSH-minor] Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Dose-Response Relationship, Drug. Drug Administration Schedule. Female. Humans. Male. Middle Aged. Neoplasm Staging. Survival Rate

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  • (PMID = 14586481.001).
  • [ISSN] 0887-6924
  • [Journal-full-title] Leukemia
  • [ISO-abbreviation] Leukemia
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase I; Clinical Trial, Phase II; Clinical Trial, Phase III; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; Q41OR9510P / Melphalan
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43. Comenzo RL, Hassoun H, Kewalramani T, Klimek V, Dhodapkar M, Reich L, Teruya-Feldstein J, Fleisher M, Filippa D, Nimer SD: Results of a phase I/II trial adding carmustine (300 mg/m2) to melphalan (200 mg/m2) in multiple myeloma patients undergoing autologous stem cell transplantation. Leukemia; 2006 Feb;20(2):345-9
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  • [Title] Results of a phase I/II trial adding carmustine (300 mg/m2) to melphalan (200 mg/m2) in multiple myeloma patients undergoing autologous stem cell transplantation.
  • Autologous stem cell transplantation (SCT) with high-dose melphalan (HDM, 200 mg/m2) is the most effective therapy for multiple myeloma.
  • To determine the feasibility of combining carmustine (300 mg/m2) with HDM, we enrolled 49 patients with previously treated Durie-Salmon stage II/III myeloma (32M/17W, median age 53) on a phase I/II trial involving escalating doses of melphalan (160, 180, 200 mg/m2).
  • HDM was safely escalated to 200 mg/m2; treatment-related mortality was 2% and > or =grade 2 pulmonary toxicity 10%.
  • We conclude that carmustine can be combined with HDM for myeloma with minimal pulmonary toxicity and a high response rate.
  • [MeSH-major] Antineoplastic Agents, Alkylating / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carmustine / administration & dosage. Melphalan / administration & dosage. Multiple Myeloma / therapy. Peripheral Blood Stem Cell Transplantation
  • [MeSH-minor] Adult. Aged. Combined Modality Therapy. Dose-Response Relationship, Drug. Female. Follow-Up Studies. Humans. Lung Diseases / chemically induced. Male. Middle Aged. Recurrence. Survival Analysis. Transplantation, Autologous

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  • (PMID = 16319952.001).
  • [ISSN] 0887-6924
  • [Journal-full-title] Leukemia
  • [ISO-abbreviation] Leukemia
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA05826
  • [Publication-type] Clinical Trial, Phase I; Clinical Trial, Phase II; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; Q41OR9510P / Melphalan; U68WG3173Y / Carmustine
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44. Alexandrakis MG, Passam FH, Kyriakou DS, Christophoridou AV, Perisinakis K, Hatzivasili A, Foudoulakis A, Castanas E: Serum level of interleukin-16 in multiple myeloma patients and its relationship to disease activity. Am J Hematol; 2004 Feb;75(2):101-6
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  • [Title] Serum level of interleukin-16 in multiple myeloma patients and its relationship to disease activity.
  • There is evidence that it may have a role in multiple myeloma (MM).
  • In the present study, we determined the serum level of IL-16 both before and after treatment of MM and related it to inflammatory markers and survival.
  • Disease stage was defined using the Durie-Salmon classification system (10 patients were in stage I, 19 in stage II, and 19 in stage III).
  • After standard treatment, 22 patients reached the plateau phase and were re-evaluated.
  • The mean +/- SD of serum IL-16 was 343 +/- 195 pg/ml in the pre-treatment MM group and 101 +/- 30 pg/ml in the control group.
  • Furthermore, IL-16, IL-6, alpha1AT, and CRP were significantly increased with increasing stage of disease, from stage I to stage III (P<0.01).
  • All parameters decreased significantly following effective chemotherapy (P<0.002).
  • Patients with a high level of IL-16 (>430 pg/ml) displayed an inferior survival time in comparison to those with lower levels of IL-16.
  • In the pre-treatment group, IL-16 correlated with alpha1AT and IL-6 (r=0.374, P<0.01 and r=0.454, P<0.002, respectively).
  • IL-16 may play a role in multiple myeloma; however, further functional studies are required.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Interleukin-16 / blood. Multiple Myeloma / blood
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Biomarkers / blood. Female. Follow-Up Studies. Humans. Inflammation / immunology. Male. Middle Aged. Neoplasm Staging. Reference Values. Survival Analysis. Time Factors

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  • [Copyright] Copyright 2004 Wiley-Liss, Inc.
  • (PMID = 14755377.001).
  • [ISSN] 0361-8609
  • [Journal-full-title] American journal of hematology
  • [ISO-abbreviation] Am. J. Hematol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers; 0 / Interleukin-16
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45. Caparrotti G, Catalano L, Feo C, Vallone R, Pagnini D, Rotoli B: Perspective study on pamidronate in stage I multiple myeloma. Hematol J; 2003;4(6):459-60
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  • [Title] Perspective study on pamidronate in stage I multiple myeloma.

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  • (PMID = 14671624.001).
  • [ISSN] 1466-4860
  • [Journal-full-title] The hematology journal : the official journal of the European Haematology Association
  • [ISO-abbreviation] Hematol. J.
  • [Language] ENG
  • [Publication-type] Clinical Trial; Comparative Study; Controlled Clinical Trial; Letter; Multicenter Study
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Diphosphonates; OYY3447OMC / pamidronate
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