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1. 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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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. 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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4. 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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5. 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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6. 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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  • (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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7. 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


8. 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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9. Sezer O, Niemöller K, Kaufmann O, Eucker J, Jakob C, Zavrski I, Possinger K: Decrease of bone marrow angiogenesis in myeloma patients achieving a remission after chemotherapy. Eur J Haematol; 2001 Apr;66(4):238-44
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  • [Title] Decrease of bone marrow angiogenesis in myeloma patients achieving a remission after chemotherapy.
  • In this report, we have estimated the bone marrow microvessel density (MVD) before and after conventional-dose or high-dose chemotherapy with autologous stem cell transplantation.
  • Immunohistochemical CD34-stained paraffin-embedded bone marrow biopsies of 21 patients with stage III multiple myeloma were studied.
  • The median MVD of all patients was 53.1 vessels/mm2 (range 15.5-174.7 vessels/mm2) before treatment and 29.3 vessels/mm2 (range 0-221.1 vessels/mm2) after chemotherapy.
  • The post-treatment MVD in the two groups of patients with and without remission was significantly different (p=0.001), whereas the pretreatment MVD was not.
  • Responders but not nonresponders showed a significant decrease of MVD after therapy in comparison to their pretreatment levels.
  • The progression-free survival in patients who achieved a reduction in MVD after chemotherapy was significantly longer than in patients without a decrease in MVD (P=0.006).
  • Furthermore, we compared the MVD of patients after achievement of a remission to MVD of 15 untreated stage I myeloma patients.
  • The MVD of patients in remission was not statistically different from the MVD in stage I myeloma.
  • These results underscore the impact of angiogenesis in myeloma and give the first report that effective chemotherapy is accompanied by a significant decrease in bone marrow angiogenesis in this disease.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / pharmacology. Bone Marrow / physiopathology. Multiple Myeloma / blood supply. Neovascularization, Pathologic / drug therapy
  • [MeSH-minor] Aged. Case-Control Studies. Disease-Free Survival. Hematopoietic Stem Cell Transplantation. Humans. Middle Aged. Remission Induction. Transplantation, Autologous. Treatment Outcome

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  • (PMID = 11380603.001).
  • [ISSN] 0902-4441
  • [Journal-full-title] European journal of haematology
  • [ISO-abbreviation] Eur. J. Haematol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Denmark
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10. Dasanu CA, Vaillant JG, Alexandrescu DT: Distinct patterns of chromonychia, Beau's lines, and melanoderma seen with vincristine, adriamycin, dexamethasone therapy for multiple myeloma. Dermatol Online J; 2006;12(6):10
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  • [Title] Distinct patterns of chromonychia, Beau's lines, and melanoderma seen with vincristine, adriamycin, dexamethasone therapy for multiple myeloma.
  • Nail and skin alterations associated with the use of chemotherapy have been described in the last decade involving various combinations of two different types of nail changes.
  • We describe a 52-year-old male diagnosed with stage III multiple myeloma, who was treated with 5-monthly cycles of VAD (vincristine, adriamycin and dexamathasone).
  • During administration of chemotherapy, the patient progressively developed a complex association of Beau's lines, transverse melanonychia, Muehrcke's lines, and diffuse hyperpigmentation of the skin.
  • This complex pattern of nail and skin changes is accounted by synergy or an additive effect of chemotherapy agents on cellular proliferation of nail compartments.
  • All changes disappeared 4 months after the discontinuation of VAD chemotherapy, which further pointed out towards adriamycin and vincristine as possible etiologic agents.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / adverse effects. Drug Eruptions / etiology. Multiple Myeloma / drug therapy. Nail Diseases / chemically induced
  • [MeSH-minor] Cell Division. Dexamethasone / administration & dosage. Dexamethasone / pharmacology. Doxorubicin / administration & dosage. Doxorubicin / pharmacology. Drug Synergism. Humans. Male. Middle Aged. Vincristine / administration & dosage. Vincristine / pharmacology

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  • (PMID = 17083890.001).
  • [ISSN] 1087-2108
  • [Journal-full-title] Dermatology online journal
  • [ISO-abbreviation] Dermatol. Online J.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 5J49Q6B70F / Vincristine; 7S5I7G3JQL / Dexamethasone; 80168379AG / Doxorubicin; VAD I protocol
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11. Garderet L, Mazurier C, Pellat-Deceunynck C, Karim A, Baudin B, Funck-Brentano C, Bouchet S, Geffroy A, Bataille R, Gorin NC, Lopez M: Poor ex vivo induction of T-cell responses to idiotype or tumor cell lysate-pulsed autologous dendritic cells in advanced pre-treated multiple myeloma. Leuk Lymphoma; 2006 Jul;47(7):1340-7
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  • [Title] Poor ex vivo induction of T-cell responses to idiotype or tumor cell lysate-pulsed autologous dendritic cells in advanced pre-treated multiple myeloma.
  • This study evaluated the feasibility of using dendritic cells (DCs) to generate, ex vivo, anti-tumor cytotoxic T lymphocytes (CTL) in patients with stage III multiple myeloma (MM).
  • Nucleated cells from eight patients who had received chemotherapy (three of whom had undergone autologous hemopoeitic stem cell transplantation) were collected by apheresis.
  • The DCs were pulsed either with the idiotypic paraprotein (regarded as a tumor-specific antigen) or with autologous MM cell lysate before co-culture.
  • Specific T-cell responses were measured in IFNgamma enzyme-linked immunospot and chromium release assays of autologous plasmocyte targets.
  • A slight increase in IFNgamma secretion by T-cells was observed for two patients (DCs pulsed with idiotypic paraprotein for one, MM cell lysate for the other).
  • In conclusion, the T-cell response to pulsed DCs was very weak or absent.
  • [MeSH-major] Cell Transplantation / methods. Dendritic Cells / cytology. Immunoglobulin Idiotypes. Multiple Myeloma / therapy. T-Lymphocytes / metabolism
  • [MeSH-minor] Adult. Aged. Blood Component Removal. CD8-Positive T-Lymphocytes / metabolism. Cell Differentiation. Chromium / metabolism. Coculture Techniques. Female. Humans. Male. Middle Aged. Monocytes / metabolism. Tumor Necrosis Factor-alpha / biosynthesis

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  • (PMID = 16923566.001).
  • [ISSN] 1042-8194
  • [Journal-full-title] Leukemia & lymphoma
  • [ISO-abbreviation] Leuk. Lymphoma
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Immunoglobulin Idiotypes; 0 / Tumor Necrosis Factor-alpha; 0R0008Q3JB / Chromium
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12. 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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13. Díaz C, Soutelo MJ, Quiroga L, Palmer L, Lutfi R: [Treatment of multiple myeloma with intravenous pamidronate. Pain prevention and suppression of hypercalcemia risk]. Medicina (B Aires); 2004;64(4):289-94
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  • [Title] [Treatment of multiple myeloma with intravenous pamidronate. Pain prevention and suppression of hypercalcemia risk].
  • [Transliterated title] Tratamiento del mieloma múltiple con pamidronato endovenoso. Mejoría del dolor y supresión del riesgo de hipercalcemia.
  • In a prospective clinical study, with the patient as its own control, we selected patients with stage III multiple myeloma.
  • The treatment tolerance was good.
  • Our observation suggests that under strict procedures, this treatment could be very adequate in patients with advanced multiple myeloma independent of the state of the disease at the beginning of the study.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Diphosphonates / therapeutic use. Hypercalcemia / prevention & control. Multiple Myeloma / drug therapy. Pain / drug therapy

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  • (PMID = 15338969.001).
  • [ISSN] 0025-7680
  • [Journal-full-title] Medicina
  • [ISO-abbreviation] Medicina (B Aires)
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Argentina
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Diphosphonates; OYY3447OMC / pamidronate
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14. Fenchel M, Konaktchieva M, Weisel K, Kraus S, Brodoefel H, Claussen CD, Horger M: Early response assessment in patients with multiple myeloma during anti-angiogenic therapy using arterial spin labelling: first clinical results. Eur Radiol; 2010 Dec;20(12):2899-906
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  • [Title] Early response assessment in patients with multiple myeloma during anti-angiogenic therapy using arterial spin labelling: first clinical results.
  • OBJECTIVE: To determine if arterial-spin-labelling (ASL) MRI can reliably detect early response to anti-angiogenic therapy in patients with multiple myeloma by comparison with clinical/haematological response.
  • Inclusion criteria were diagnosis of stage III multiple myeloma and clinical indication for therapeutical administration of bortezomib or lenalidomide.
  • We performed MRI on 3.0T MR in the baseline setting, 3 weeks after onset of therapy and after 8 weeks.
  • RESULTS: Fifteen patients responded to anti-myeloma therapy; 4/19 patients were non-responders to therapy.
  • Mean tumour perfusion assessed by ASL-MRI in a reference lesion was 220.7 ± 132.5 ml min(-1) 100 g(-1) at baseline, and decreased to 125.7 ± 86.3 (134.5 ± 150.9) ml min(-1) 100 g(-1) 3 (8) weeks after onset of therapy (P < 0.02).
  • CONCLUSION: ASL tumour perfusion measurements are a valuable surrogate parameter for early assessment of response to novel anti-angiogenic therapy.
  • [MeSH-major] Boronic Acids / therapeutic use. Magnetic Resonance Imaging / methods. Multiple Myeloma / diagnosis. Multiple Myeloma / drug therapy. Pyrazines / therapeutic use. Thalidomide / analogs & derivatives
  • [MeSH-minor] Aged. Angiogenesis Inhibitors / therapeutic use. Bortezomib. Female. Humans. Male. Middle Aged. Pilot Projects. Reproducibility of Results. Sensitivity and Specificity. Spin Labels. Treatment Outcome

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  • (PMID = 20589379.001).
  • [ISSN] 1432-1084
  • [Journal-full-title] European radiology
  • [ISO-abbreviation] Eur Radiol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Angiogenesis Inhibitors; 0 / Boronic Acids; 0 / Pyrazines; 0 / Spin Labels; 4Z8R6ORS6L / Thalidomide; 69G8BD63PP / Bortezomib; F0P408N6V4 / lenalidomide
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15. Fenchel M, Konaktchieva M, Weisel K, Kraus S, Claussen CD, Horger M: Response assessment in patients with multiple myeloma during antiangiogenic therapy using arterial spin labeling and diffusion-weighted imaging: a feasibility study. Acad Radiol; 2010 Nov;17(11):1326-33
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Response assessment in patients with multiple myeloma during antiangiogenic therapy using arterial spin labeling and diffusion-weighted imaging: a feasibility study.
  • RATIONALE AND OBJECTIVES: To determine whether response to anti-angiogenic therapy in patients with multiple myeloma can be assessed by noncontrast perfusion magnetic resonance imaging (MRI) (ie, arterial-spin-labeling [ASL]), and diffusion-weighted [DWI] MRI.
  • Ten consecutive patients (eight men, two women; mean age 60.5 ± 8.5 years) with Stage III multiple myeloma were prospectively included.
  • MRI was performed at baseline, as well as 3 and 8 weeks after onset of antiangiogenic therapy.
  • RESULTS: Nine patients responded well to therapy, whereas one patient was classified a nonresponder.
  • CONCLUSION: ASL perfusion as well as DWI-MRI provide accurate, clinically relevant information regarding tumor viability and can predict response already early after therapy onset, as opposed to classical lesion size and MRI signal-intensity measurements.
  • [MeSH-major] Angiogenesis Inhibitors / administration & dosage. Diffusion Magnetic Resonance Imaging / methods. Magnetic Resonance Angiography / methods. Multiple Myeloma / drug therapy. Multiple Myeloma / pathology. Neovascularization, Pathologic / drug therapy. Neovascularization, Pathologic / pathology
  • [MeSH-minor] Feasibility Studies. Female. Humans. Image Enhancement / methods. Male. Middle Aged. Prognosis. Reproducibility of Results. Sensitivity and Specificity. Spin Labels. Treatment Outcome

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  • [Copyright] Copyright © 2010 AUR. Published by Elsevier Inc. All rights reserved.
  • (PMID = 20817572.001).
  • [ISSN] 1878-4046
  • [Journal-full-title] Academic radiology
  • [ISO-abbreviation] Acad Radiol
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Angiogenesis Inhibitors; 0 / Spin Labels
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16. 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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17. Berz D, Colvin GA, McCormack EM, Winer ES, Karwan P, Colvin L, Rathore R, Lum LG, Elfenbein GJ, Quesenberry PJ: Triple MEL100 therapy in multiple myeloma. Transplant Proc; 2009 Nov;41(9):3863-7
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  • [Title] Triple MEL100 therapy in multiple myeloma.
  • BACKGROUND: Tandem high-dose melphalan therapy with autologous peripheral stem cell support has emerged as the standard of care for patients without prohibitive comorbidities.
  • Two previously published studies presented a triple transplant with a conditioning regimen of melphalan 100 mg/m(2) (MEL100) with peripheral stem cell support every 2 to 5 months for patients with prohibitive comorbidities for high-dose tandem transplantation.
  • PATIENTS AND METHODS: Thirteen standard or high-risk patients with stage III multiple myeloma were prospectively treated.
  • Seven patients (54%) received the treatments on the every-3-weeks schedule; three treatments (23%) during the second cycle and six treatments (46%) of the third cycle had to be delayed a median of 6 and 4 days, respectively.
  • CONCLUSION: Our regimen of three consecutive autologous peripheral stem cell transplants with a reduced dose of melphalan at 100 mg/m(2) given every 3 weeks was very well tolerated.
  • The progression-free survival and overall survival are similar and can be compared favorably with the standard tandem myeloma regimens.
  • [MeSH-major] Melphalan / therapeutic use. Multiple Myeloma / drug therapy. Multiple Myeloma / surgery
  • [MeSH-minor] Antineoplastic Agents, Alkylating / administration & dosage. Antineoplastic Agents, Alkylating / therapeutic use. Combined Modality Therapy. Disease Progression. Drug Administration Schedule. Humans. Neoplasm Staging. Stem Cell Transplantation. Transplantation, Autologous

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  • (PMID = 19917402.001).
  • [ISSN] 1873-2623
  • [Journal-full-title] Transplantation proceedings
  • [ISO-abbreviation] Transplant. Proc.
  • [Language] eng
  • [Grant] United States / NCRR NIH HHS / RR / P20 RR025179-01
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; Q41OR9510P / Melphalan
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18. 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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  • [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


19. Labidi SI, Sebban C, Ghesquières H, Nicolas EV, Biron P: Hepatic veno-occlusive disease after tandem autologous stem cell transplantation conditioned by melphalan. Int J Hematol; 2008 Oct;88(3):291-3
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  • [Title] Hepatic veno-occlusive disease after tandem autologous stem cell transplantation conditioned by melphalan.
  • We report the case of a 58-year-old man with multiple myeloma stage III A who received tandem autologous stem cell transplantation after induction by two courses of VAD and three cycles of bortezomib-dexamethasone, due to progression under chemotherapy.
  • [MeSH-major] Hepatic Veno-Occlusive Disease / chemically induced. Melphalan / adverse effects. Myeloablative Agonists / adverse effects. Stem Cell Transplantation. Transplantation Conditioning / adverse effects
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Boronic Acids / administration & dosage. Boronic Acids / adverse effects. Bortezomib. Dexamethasone / administration & dosage. Doxorubicin / administration & dosage. Etoposide / administration & dosage. Humans. Male. Middle Aged. Multiple Myeloma / therapy. Pyrazines / administration & dosage. Pyrazines / adverse effects. Transplantation, Autologous

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  • (PMID = 18696182.001).
  • [ISSN] 1865-3774
  • [Journal-full-title] International journal of hematology
  • [ISO-abbreviation] Int. J. Hematol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Boronic Acids; 0 / Myeloablative Agonists; 0 / Pyrazines; 69G8BD63PP / Bortezomib; 6PLQ3CP4P3 / Etoposide; 7S5I7G3JQL / Dexamethasone; 80168379AG / Doxorubicin; Q41OR9510P / Melphalan; VAD combination
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20. 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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21. 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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22. 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).
  • Of the 242 patients studied, 75% had IgG M-protein and 25% IgA; MM stages: I: 1%, II: 35% and III: 64%.
  • 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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23. 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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24. 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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25. 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).
  • Infections (all grades) were more commonly seen in the VAD arm (P = 0.001) although grade III/IV infections were not significantly different between the two groups (P = 0.081).
  • 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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26. 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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27. 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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28. 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


29. 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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30. 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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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.
  • The median survival of patients with ISS stages I, II and III were 79, 49 and 43 months, respectively.
  • 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. 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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34. 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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