Document Detail


Treatment of newly diagnosed myeloma.
MedLine Citation:
PMID:  19005483     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The introduction of thalidomide, bortezomib and lenalidomide has dramatically changed the treatment paradigm of multiple myeloma (MM). In patients eligible for autologous stem cell transplant (ASCT), combinations including thalidomide/dexamethasone (Thal/Dex) or bortezomib/dexamethasone (Bort/Dex) or lenalidomide/dexamethasone (Rev/Dex) have been introduced as induction regimens in patients eligible for ASCT. New induction regimens have significantly increased complete response rate before and after ASCT with a positive impact on progression-free survival. Maintenance therapy with thalidomide, under investigation with lenalidomide, may further prolong remission duration. In patients not eligible for ASCT, randomized studies have shown that melphalan, prednisone, thalidomide (MPT) and melphalan, prednisone and bortezomib (MPV) are both superior to melphalan and prednisone (MP), and are now considered standard of care. Ongoing trials will soon assess if MP plus lenalidomide may be considered an attractive option. More complex regimens combining thalidomide or bortezomib or lenalidomide with cyclophosphamide or doxorubicin have been also tested. In small cohorts of patients bortezomib or lenalidomide may overcome the poor prognosis induced by deletion 13 or translocation t(4;14) or deletion 17p13. If these data will be confirmed, a cytogenetically risk-adapted strategy might become the most appropriate strategy.
Authors:
A Palumbo; S V Rajkumar
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review     Date:  2008-11-13
Journal Detail:
Title:  Leukemia     Volume:  23     ISSN:  1476-5551     ISO Abbreviation:  Leukemia     Publication Date:  2009 Mar 
Date Detail:
Created Date:  2009-03-11     Completed Date:  2009-04-08     Revised Date:  2014-05-29    
Medline Journal Info:
Nlm Unique ID:  8704895     Medline TA:  Leukemia     Country:  England    
Other Details:
Languages:  eng     Pagination:  449-56     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Angiogenesis Inhibitors / administration & dosage,  therapeutic use
Antineoplastic Combined Chemotherapy Protocols / administration & dosage,  therapeutic use
Boronic Acids / administration & dosage
Chromosome Deletion
Clinical Trials as Topic / statistics & numerical data
Combined Modality Therapy
Hematopoietic Stem Cell Transplantation
Humans
Immunologic Factors / administration & dosage,  therapeutic use
Middle Aged
Multiple Myeloma / diagnosis,  drug therapy,  genetics,  surgery,  therapy*
Myeloma Proteins / analysis
Prognosis
Pyrazines / administration & dosage
Risk
Thalidomide / administration & dosage,  analogs & derivatives
Translocation, Genetic
Transplantation Conditioning
Grant Support
ID/Acronym/Agency:
CA 100080/CA/NCI NIH HHS; CA 62242/CA/NCI NIH HHS; CA 93842/CA/NCI NIH HHS; CA107476/CA/NCI NIH HHS; P01 CA062242/CA/NCI NIH HHS; R01 CA093842/CA/NCI NIH HHS; R01 CA100080/CA/NCI NIH HHS; R01 CA107476/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/Angiogenesis Inhibitors; 0/Boronic Acids; 0/Immunologic Factors; 0/Myeloma Proteins; 0/Pyrazines; 0/bortezomib; 191732-72-6/lenalidomide; 4Z8R6ORS6L/Thalidomide
Comments/Corrections

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