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Breakthroughs in the management of multiple myeloma.

Although multiple myeloma remains a terminal illness, the past four decades have seen a dramatic change in the outlook for a newly diagnosed patient in terms of therapies available, supportive care and insight into the pathogenesis of this disease. Among the newer agents available for treatment, thalidomide has been resurrected and discovered to be a valuable therapy for myeloma. Thalidomide appears to work, at least in part, through its anti-angiogenic properties, but much remains to be learned about its mechanism of action as well as optimal administration regimens. With the development of i…

Interferon in the Treatment of Multiple Myeloma.

BACKGROUND: The role of interferon (IFN) in the treatment of multiple myeloma has been investigated for nearly two decades. The mechanisms underlying antitumor activity of IFN may be mediated by antiproliferative and immunomodulatory effects. The benefits of treatment remain controversial, and guidelines for the use of IFN in myeloma are needed. This review evaluates available data on the impact of IFN therapy on multiple myeloma. METHODS: A MEDLINE search of published prospective, randomized trials of IFN in multiple myeloma provided the data included in this review, as well as selected abstr…

Biology and treatment of multiple myeloma.

The uniformly fatal plasma cell malignancy, multiple myeloma (MM), currently represents 10-15% of hematologic neoplasms in the USA and has been steadily increasing in incidence for several decades. Therapeutic alternatives have lagged significantly behind insights into the biology and pathogenesis of this entity. Traditionally felt to be a neoplasm of fully differentiated plasma cells, evidence has been mounting that the self renewing population consist of cells derived from a much earlier compartment; perhaps prior to B-cell lineage commitment or even at the level of an earlier 'stem cell'. B…

[The biology and pathogenesis of multiple myeloma].

Some questions regarding multiple myeloma pathogenesis (MM) still have to be resolved. Various and non univocal mutational events underlie the arising of this disease. These lesions involve various proto-oncogene loci which code for proteins involved in the control of normal cellular growth and differentiation. However, it has not been resolved as to whether the myeloma cells derive from plasma cells which have arisen in response to foreign antigen or if they are autoreactive clone instead. In both cases this clone has an unusual survival potential helped by a defect of the normal regulatory s…

Multiple myeloma of the bladder and vagina.

A case is described of multiple myeloma with involvement of the urinary bladder and vagina. The patient was admitted with hematuria and postrenal obstruction. She was treated successfully with local radiotherapy and combination chemotherapy with vincristine, Adriamycin (doxorubicin), and dexamethasone (VAD).

Radiotherapy in the treatment of multiple myeloma.

Fifty-nine patients with multiple myeloma referred for treatment of painful bony lesions received irradiation to 95 local areas, and 16 of the 59 were irradiated using hemibody techniques. Pain relief was obtained in practically all of the irradiated regions. Most local areas were treated to doses of 3000 cGy in 10 to 15 fractions. Patients with generalized pain due to multiple site involvement were treated with single dose hemibody irradiation, to doses of 600 cGy to the upper hemibody, and of 800 cGy to the lower hemibody. This treatment was well tolerated and side effects minimal. Median su…

[The clinical picture of multiple myeloma].

Diagnosis of multiple myeloma is based on the triad paraproteinemia, osteolytic bone lesions and bone marrow plasma cell infiltration. Clinically, rheumatoid-like pain induced by osteolytic skeletal lesions often prevails. Occasionally, foudroyant bacterial infections - the most frequent cause of death in myelomatosis - or acute/subacute renal failure or rarely, acute hemi- or paraparesis precede diagnosis. Establishment of diagnosis early in the course of the disease and improved cytostatic and symptomatic treatment has led to a decrease in episodes of hyperviscosity-syndromes. Severe renal i…

[Progress in metabolomics of multiple myeloma].

Multiple myeloma (MM) is a malignant disease characterized by clonal plasma cell proliferation, with metabolic reprogramming. Abnormal metabolism of amino acids, glucose, lipids and nucleotides plays a crucial role in various pathological processes in MM, such as proliferation, metastasis, immune escaping and drug resistance. This review summarized the application of metabolomics technology in identifying biomarkers for MM and targeting related metabolic pathways. The objective is to guide further investigations into the metabolic mechanisms underlying MM and encourage innovation in clinical d…

Role of BACH1 in multiple myeloma.

OBJECTIVE: Examine Bach1 protein expression in bone marrow biopsy specimens obtained from newly diagnosed multiple myeloma (NDMM) and iron deficiency anemia (IDA) patients. Conduct a thorough analysis to explore the potential connection between Bach1 and the onset as well as treatment response of NDMM. METHODS: This study investigated Bach1 expression in bone marrow biopsy tissues from NDMM and IDA patients. Immunohistochemical staining and Image-pro Plus software were utilized for quantitatively obtaining the expression level of Bach1 protein. Arrange Bach1 expression levels from high to low…

In search for cure of multiple myeloma.

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… Allogeneic stem cell transplantation in multiple myeloma. Cancers (Basel). 2021;14(1):55. 4. Maloney DG, Molina AJ, Sahebi F, et al. Allografting with nonmyeloablative conditioning following cytoreductive autografts for the treatment of patients with multiple myeloma. … Safety and efficacy of vorinostat, bortezomib, doxorubicin and dexamethasone in a phase I/II study for relapsed or refractory multiple myeloma (VERUMM study: vorinostat in elderly, relapsed and unfit multiple myeloma). Haematologica. 2018;103(10):e473-e479. 6. …

The role of staging in multiple myeloma.

INTRODUCTION: The importance of cancer staging is determined by how accurately it can predict prognosis, and how useful it is for treatment decisions. Compared to other malignancies, multiple myeloma (MM) staging proved more challenging because of unreliable prognostic factors and wide-ranging life expectancy. As traditional MM staging continues to evolve, it requires reassessment of its prognostic and predictive value. AREAS COVERED: The studies that included prognostic and predictive value of MM stages from 1975 through 2023 were selected for this review using PubMed, MEDLINE platforms. The…

Isatuximab for the treatment of multiple myeloma.

Isatuximab is an IgG1 monoclonal antibody targeting CD38 that has received regulatory approval in combination regimens for patients with relapsed/refractory multiple myeloma. CD38 is an antigen with high surface expression on multiple myeloma cells. While daratumumab holds most of the market share for this drug class, isatuximab offers several unique aspects including a mechanism of action that may involve more direct myeloma-cell inhibition and killing and less reliance on cross-linking and immune effector cells, as well as subgroup data from pivotal trials showing notable efficacy in populat…