| | |  | | | | Record from Web of Science® | | | | | | |
| Treatment of multiple myeloma |
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| Author(s): Barlogie B, Shaughnessy J, Tricot G, Jacobson J, Zangari M, Anaissie E, Walker R, Crowley J |
| Source: BLOOD Volume: 103 Issue: 1 Pages: 20-32 Published: JAN 1 2004 |
| Times Cited: 221 References: 148 |
| Abstract: Autologous peripheral blood stem cell (PBSC)-supported high-dose melphalan is now considered standard therapy for myeloma, at least for younger patients. The markedly reduced toxicity of allotransplants using nonmyeloablative regimens (mini-allotransplantations) may hold promise for more widely exploiting the well-documented graft-versus-myeloma (GVM) effect. New active drugs include immunomodulatory agents, such as thalidomide and CC-5013 (Revimid; Celgene, Warren, NJ), and the proteasome inhibitor, PS 341 (Velcade; Millenium, Cambridge, MA), all of which not only target myeloma cells directly but also exert an indirect effect by suppressing growth and survival signals elaborated by the bone marrow microenvironment's interaction with myeloma cells. Among the prognostic factors evaluated, cytogenetic abnormalities (CAs), which are present in one third of patients with newly diagnosed disease, identify a particularly poor prognosis subgroup with a median survival not exceeding 2 to 3 years. By contrast, in the absence of CAs, 4-year survival rates of 80% to 90% can be obtained with tandem autotransplantations. Fundamental and clinical research should, therefore, focus on the molecular and biologic mechanisms of treatment failure in the high-risk subgroup. |
| Document Type: Review |
| Language: English |
| Reprint Address: Barlogie, B (reprint author), Univ Arkansas Med Sci, Myeloma Inst Res & Therapy, 4301 W Markham,No 816, Little Rock, AR 72205 USA |
Addresses:
1. Univ Arkansas Med Sci, Myeloma Inst Res & Therapy, Little Rock, AR 72205 USA |
| Publisher: AMER SOC HEMATOLOGY, 1900 M STREET. NW SUITE 200, WASHINGTON, DC 20036 USA |
| Subject Category: Hematology |
| IDS Number: 757QM |
| ISSN: 0006-4971 |
| DOI: 10.1182/blood-2003-04-1045 |
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| | | | | | | | | Record from Web of Science® | | | | | | | | | |