Treatment of myeloma: recent developments
作者:
S Zweegman,
PC Huijgens,
期刊:
Anti-Cancer Drugs
(OVID Available online 2002)
卷期:
Volume 13,
issue 4
页码: 339-351
ISSN:0959-4973
年代: 2002
出版商: OVID
关键词: Allogenic transplantation;melphalan;multiple myeloma
数据来源: OVID
摘要:
Melphalan was the first described treatment for patients with multiple myeloma in the 1960s and is still being used in clinical practice. However, the use of melphalan in combination with prednisone resulted in a median survival of only 2–3 years. Therefore, the dose of melphalan has been intensified since then (140–200 mg/m2). In order to diminish treatment-related morbidity and mortality due to severe myelosuppression induced by these regimens, high-dose melphalan is currently supported with autologous stem cells. Indications for high-dose therapy and the role of further intensification by performing second or allogeneic transplantations are discussed. Furthermore, new therapeutic modalities, such as inhibitors of angiogenesis, also showing direct antiproliferative, cytokine-related and immunomodulatory effects on plasma cells (thalidomide and its newer deratives), inhibitors of the transcription factor NF-&kgr;B (proteasome inhibitors) and immunotherapy are described.
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