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New Velcade®-melphalan Transplant Regimen for Multiple Myeloma (11/20/2009)
Researchers from France have reported encouraging results with adding Velcade® (bortezomib) to high-dose melphalan followed by autologus stem cell infusion for initial treatment of patients with newly diagnosed multiple myeloma. The details of this Phase II study appeared in an early online publication in Blood on November 2, 2009.
Addition of Thalomid® to Autologous Stem Cell Transplantation May Improve Outcomes in Patients with Myeloma (10/23/2009)
Researchers from Italy have reported that “the addition of first-line thalidomide to double ASCT [autologous stem cell transplant] improved clinical outcomes” for patients with multiple myeloma. The details of this study appeared in the October 20, 2009 issue of the Journal of Clinical Oncology.
New Proteasome Inhibitor, Carfilzomab, Has Significant Activity in Relapsed Myeloma (10/6/2009)
Researchers affiliated with the Multiple Myeloma Research Consortium (MMRC) have reported that carfilzomab monotherapy is highly active in patients with relapsed myeloma and can be administered safely for at least one year in responding patients. The details of this study were presented at the Joint ECCO 15-34th ESMO Multidisciplinary Congress in Berlin, September 20-24, 2009.
Pomalidomide Active for Treatment of Anemia of Myelofibrosis (8/21/2009)
Researchers involved in an international trial have reported that pomalidomide is active for the treatment of anemia associated with myelofibrosis. The details of this study appeared in an early online publication in the Journal of Clinical Oncology on August 3, 2009.
Pesticides Linked to Monoclonal Gammopathy of Undetermined Significance (MGUS) (7/1/2009)
Researchers from the National Cancer Institute have reported that individuals who apply pesticides to crops are twice as likely as the general population to develop monoclonal gammopathy of undetermined significance (MGUS), which can lead to multiple myeloma. The details of this study appeared in the June 18, 2009 issue of Blood.
Formaldehyde Exposure May Increase Risk of Blood and Lymphatic Cancers (6/25/2009)
Researchers from the National Cancer Institute have reported that industrial workers who are exposed to formaldehyde may be at an increased risk of dying from blood and lymphohematopoietic malignancies, particularly myeloid leukemia but also Hodgkin’s lymphoma and multiple myeloma, according to the results of a study published in the Journal of the National Cancer Institute.
Mozobil™ Increases Autologous Peripheral Blood Stem Cell Harvests in Myeloma Patients (5/7/2009)
Researchers from several U.S. medical centers have reported that the addition of Mozobil® (plerixafor, AMD3100) to Neupogen® (filgrastim) significantly increases the efficiency of autologous peripheral blood stem cell harvests in patients with multiple myeloma. The details of this study appeared in an early online publication in Blood on April 10, 2009.
Thalidomid® Consolidation After Autologous Transplant Improves Outcomes in Myeloma (4/14/2009)
Researchers from Australia have reported that one year of low-dose Thalomid® (thalidomide) after a single autologous transplant prolongs survival of patients with multiple myeloma. The details of this study appeared in the April 10, 2009 issue of the Journal of Clinical Oncology.
Revlimid®-based Regimen with Neulasta® Support Very Effective for Relapsed Myeloma (3/18/2009)
Researchers affiliated with the German Myeloma Study Group have reported that a regimen of Revlimid® (lenalidomide), Adriamycin® (doxorubicin), and dexamethasone supported by Neulasta® (pegfilgrastim) resulted in a 74% complete or very good partial remission rate in patients with relapsed and refractory multiple myeloma. The details of this study appeared in an early online publication in Blood of January 30, 2009.
In-vitro Studies Suggest that Green Tea May Interfere with Velcade® (3/17/2009)
Researchers from the University of Southern California have reported that consumption of green tea may be contraindicated for patients who are receiving treatment with Velcade® (bortezomib), as the polyphenols in green tea may negate the therapeutic benefits of the drug. The details of this in-vitro study were announced in an early online publication in Blood on February 3, 2009.
Revlimid®, Melphalan, Prednisone, and Thalomid® Effective for Relapsed Myeloma (3/3/2009)
Researchers from Italy have reported that the combination of Revlimid® (lenalidomide), melphalan, prednisone, and Thalomid® (thalidomide) results in a 76% response rate in patients with relapsed or refractory multiple myeloma. The details of this study were presented on December 9 at the 2008 meeting of the American Society of Hematology.
New Agents for the Treatment of Multiple Myeloma Presented at ASH 2008 (1/23/2009)
At the 2008 meeting of the American Society of Hematology in San Francisco in December, there were several oral presentations of new and promising agents for the treatment of patients with multiple myeloma.
Revlimid® Combinations for Newly Diagnosed Multiple Myeloma Reported at ASH 2008 (1/23/2009)
At the 2008 meeting of the American Society of Hematology in December there were several oral presentations on the outcomes of newly diagnosed patients with multiple myeloma where Revlimid® (lenalidomide) was incorporated into the induction or maintenance regimens.
Velcade® Combinations for Newly Diagnosed Patients with Multiple Myeloma at ASH 2008 (1/22/2009)
At the 2008 meeting of the American Society of Hematology in December in San Francisco, there were several oral presentations on the outcomes of newly diagnosed patients with multiple myeloma where Velcade® (bortezomib) was incorporated into the induction regimen.
Velcade® and Perifosine Effective in Relapsed Multiple Myeloma Previously Treated with Velcade (1/22/2009)
Researchers from several U.S. institutions have reported a 40% overall response rate to the combination of perifosine and Velcade® (bortizomib) in patients with multiple myeloma who had been previously treated with Velcade. The details of this study were presented at the 2008 meeting of the American Society of Hematology on December 9 in San Francisco.
Velcade®, Cytoxan® and Prednisone Highly Effective for Relapsed Myeloma (10/15/2008)
Researchers from Canada have reported that the combination of Velcade (bortezomib) plus oral Cytoxan (cyclophosphamide) and prednisone produces complete responses in 50% of patients with relapsed or refractory multiple myeloma. The details of this study appeared in the October 10, 2008 issue of the Journal of Clinical Oncology.
Zometa® Decreases Skeletal-related Events but Does Not Improve Time to Progression in Patients with Asymptomatic Untreated Myeloma (9/25/2008)
Researchers from Italy have reported that the administration of Zometa® (zoledronic acid) decreases skeletal-related events in patients with untreated asymptomatic multiple myeloma but does not improve time to progression. The details of this study appeared in the October 1, 2008 issue of Cancer.
Thalomid® in Induction Improves Progression-free Survival in Elderly with Myeloma (9/11/2008)
An Italian multicenter randomized trial has determined that elderly patients with multiple myeloma treated with Thalomid® (thalidomide) in addition to melphalan and prednisone (MP) have an improved response rate and delayed time to relapse but not an improved survival compared with patients receiving MP alone. The details of this study were originally published in the March 11, 2006, issue of The Lancet and updated in an early online publication in Blood on April 1, 2008.
Velcade®, Melphalan, and Prednisone Improves Survival of Patients with Multiple Myeloma Not Eligible for Transplant (9/3/2008)
Researchers affiliated with the VISTA international study have reported that VMP (Velcade® [bortezomib], melphalan, and prednisone) improves survival of patients with multiple myeloma who are not candidates for stem cell transplantation compared with the classic MP (melphalan and prednisone) regimen. The details of this randomized study were presented at the 2007 meeting of the American Society of Hematology in December in Atlanta, Georgia, and have now been published in the August 28, 2008 issue of the New England Journal of Medicine.
Long-term Effects of Thalomid® for Treatment of Myeloma Reported (7/30/2008)
Three recent publications in Blood have confirmed that Thalomid® (thalidomide) is an important addition to treatment regimens for patients with multiple myeloma.
Does a 10-year 10% Continuous Complete Remission Rate for Myeloma Patients Suggest Cure? (6/19/2008)
Researchers from the University of Arkansas have reported a 10% continuous complete remission rate for patients with newly diagnosed multiple myeloma (MM) who are treated with chemotherapy induction, tandem autotransplants, and interferon maintenance. These researchers also suggest that continued improvements in a “total therapy” (TT) approach should increase this 10% “cure” rate. The details of this study were presented at the 2008 meeting of the American Society of Clinical Oncology in Chicago, May 30-June 2.
High-Dose Dexamethasone Increases Mortality Compared to Low-Dose Dexamethasone When Combined with Revlimid® (Lenolidomide) for Multiple Myeloma (1/18/2008)
Researchers affiliated with the Eastern Cooperative Group (Study E4A03) have reported that Revlimid® (lenalidomide) plus high-dose dexamethasone (dex) is associated with a higher death rate than seen following Revlimid and low-dose dex for initial treatment of patients with multiple myeloma. The details of this randomized trial were presented at the 2007 meeting of the American Society of Hematology in December in Atlanta, Georgia.
Better Responses to Revlimid® (Lenalidomide) and Dexamethasone Compared to Dexamethasone Alone for Initial Treatment of Multiple Myeloma (1/18/2008)
Researchers affiliated with the Southwest Oncology Group study 0232 have reported that Revlimid® (lenalidomide) plus high-dose (HD) dexamethasone (dex) results in a higher response rate than dex alone for initial treatment of patients with multiple myeloma. The details of this study were reported at the 2007 meeting of the American Society of Hematology in December in Atalanta, Georgia.
Velcade® (Bortezomib), Melphalan and Dexamethasone Improves Survival of Patients with Multiple Myeloma Who are not Transplant Candidates (1/16/2008)
Researchers affiliated with the VISTA international study have reported that VMP (Velcade® (bortezomib), melphalan and prednisone) improves survival of patients with multiple myeloma who are not candidates for stem cell transplantation compared to the classic MP (melphalan and prednisone) regimen. The details of this randomized study were presented at the 2007 meeting of the American Society of Hematology in December in Atlanta, Georgia.
Thalomid® (Thalidomide) Prolongs Survival in Elderly Patients with Multiple Myeloma (1/16/2008)
Researchers affiliated with the Intergroupe Francophone du Myelome (IFM) 01-01 study have reported that a regimen of melphalan, prednisone and Thalomid® (thalidomide) (MPT) is superior to the classic melphalan and prednisone (MP) regimen for the treatment of elderly patients with multiple myeloma. The details of this study were presented at the 2007 meeting of the American Society of Hematology in December in Atlanta, Georgia.
Velcade® (Bortezomib) Induction Improves Outcomes of Patients with Myeloma Receiving Stem Cell Transplants (1/15/2008)
Researchers affiliated with the IFM 1005/01 Trial have reported that an induction regimen of Velcade® (bortezomib) and dexamethasone (Vel/D) was superior to the standard regimen of VAD (vincristine, doxorubicin and dexamethasone) with a higher response rate that led to a higher response rate after autologous stem cell transplant (ASCT). The details of this randomized study were presented at the 2007 meeting of the American Society of Hematology in December in Atlanta, Georgia.
Velcade® (Bortezomib) Adds to Effectiveness of Thalomid® (Thalidomide) and Dexamethasone for Myeloma (1/14/2008)
Researchers affiliated with the Italian Myeloma Network have reported that a regimen of Velcade (bortezomib), Thalomid (thalidomide) and dexamethasone (VDT) results in a higher complete response rate than Thalomid and dexamethasone (TD) for the initial treatment of patients with multiple myeloma. The details of this randomized trial were presented at the 2007 meeting of the American Society of Hematology in December in Atlanta, Georgia.
Revlimid® Plus Dexamethasone Improves Survival in Relapsed Multiple Myeloma (11/26/2007)
Two randomized controlled trials have reported that Revlimid (linalidomide) plus dexamethasone is superior to dexamethasone alone for the treatment of relapsed multiple myeloma. The details of these studies appeared in the November 22, 2007 issue of The New England Journal of Medicine.
Umbilical Cord Blood Transplantation with Reduced Intensity Regimen Effective (11/14/2007)
Researchers from the University of Minnesota have reported that adults with hematological diseases have a three year survival of almost 50% following umbilical cord blood transplantation after a reduced intensity treatment regimen. The details of this study appeared in the October 15, 2007 issue of Blood.
Velcade® Indication Expanded to Include Patients with Impaired Kidney Function (10/17/2007)
Millennium Pharmaceuticals, Inc. has received an expanded indication for their agent Velcade (bortezomib) from the United States Food and Drug Administration (FDA) to include patients with multiple myeloma who have impaired kidney function, including those who require dialysis.
Melphalan, Prednisone and Revlimid for Induction Theapy of Multiple Myeloma (10/12/2007)
Researchers from Italy have reported that a regime of melphalan, prednisone and Revlimid (lenalidomide) produces a partial response or greater in 81% of newly diagnosed patients with multiple myeloma. The details of this study appeared in the October 1, 2007 issue of the Journal of Clinical Oncology.
Thalomid®/Melphalan/Prednisone in Newly Diagnosed Elderly Multiple Myeloma Patients (10/12/2007)
Researchers from France have reported that the addition of Thalomid (thalidomide) to standard melphalan/prednisone (MP) improves progression-free and overall survival compared to either MP or MEL-100 and autologous stem cell support in newly diagnosed, elderly multiple myeloma patients. The researchers suggested that Thalomid/MP (MPT) become the new reference treatment in future clinical trials for newly diagnosed, elderly multiple myeloma patients. The results from this Phase III trial were presented at a plenary session at the 42nd annual meeting of the American Society of Clinical Oncology (ASCO) in 2006 and full details were published in the October 6, 2007 issue of the Lancet.
Velcade® Alternating with Dexamethasone Effective for Induction of Myeloma Patients Scheduled for Autologous Transplantation (10/9/2007)
Researchers from Spain have reported that alternating Velcade (bortezomib) and dexamethasone produce partial a response (PR) or greater in 65% of multiple myeloma patients under the age of 66 years who are having an autologous stem cell transplant. The details of this report appeared in the October 1, 2007 issue of the Journal of Clinical Oncology.
VAD-Doxil®/Thalomid® Confirmed Better than VAD-Doxil® for Myeloma (8/20/2007)
Researchers from Greece have reported that VAD (vincristine, liposomal doxorubicin and dexamethasone)-Doxil plus Thalomid (thalidomide) improves response and progression-free survival rates in newly diagnosed patients with multiple myeloma. The details of this randomized study were published in the August, 2007 issue of Annals of Oncology.
Obesity Increases Risk of Multiple Myeloma (7/30/2007)
Researchers from Harvard have reported that being overweight or obese significantly increases the risk of developing multiple myeloma. The details of this study appeared as an early on-line publication in Cancer Epidemiology, Biomarkers and Prevention.
Study Tracks Progression from Smoldering to Active Multiple Myeloma (6/28/2007)
Researchers from the Mayo Clinic have reported that the risk of progression from smoldering to symptomatic myeloma is related to the proportion of bone marrow plasma cells and the serum monoclonal protein level at the time of diagnosis. The details of this study appeared in the June 21, 2007 issue of the New England Journal of Medicine.
Double Autografts Improve Progression-Free Survival in Patients with Myeloma (6/26/2007)
Researchers from Italy have reported that newly diagnosed patients with multiple myeloma have improved responses and relapse-free and event-free survivals following double autologous transplants compared to a single autologous transplant but there was no improvement in overall survival. The details of this study were published in the June 10, 2007 issue of the Journal of Clinical Oncology.
Adjuvant Peg-Interferon Improves Progression-Free Survival in Stage III Melanoma (6/19/2007)
Researchers affiliated with the European Organization for Research and Treatment of Cancer (EORTC) Trial 18991 have reported that long-term adjuvant therapy with pegylated interferon-alpha 2b (Peg-IFN) improved rates of relapse-free survival in patients with stage III melanoma compared with observation alone. The details of this study were presented at the 2007 meeting of the American Society of Clinical Oncology.
Doxil® Approved for Multiple Myeloma in Combination with Velcade® (5/24/2007)
The US Food and Drug Administration (FDA) announced on May 17, 2007 the approval of Doxil (liposomal doxorubicin) plus Velcade for the treatment of patients with multiple myeloma who had failed at least one prior regimen and had not been treated with Velcade (vortezomib).
Allogeneic Superior to Autologous Stem Cell Transplants for Multiple Myeloma (3/16/2007)
Researchers from Italy have reported that patients with multiple myeloma have a better survival after receiving an allogeneic stem cell transplant following an autologous stem cell transplant than following tandem autologous stem cell transplantation. The details of this study appeared in the March 15, 2007 issue of the New England Journal of Medicine.
Velcade® Safe and Effective for Patients with Multiple Myeloma and Renal Failure (3/15/2007)
Researchers from Roswell Park Cancer Center, Emory University, Northwestern University and the Dana-Farber Cancer Center have reported that Velcade (bortezomib) and Velcade containing regimens can be used in patients with multiple myeloma requiring renal dialysis. The details of this retrospective study were published in the March 15, 2007 issue of Blood.
FDA Agrees to Review Supplemental New Drug Application for Doxil® Plus Velcade® in Multiple Myeloma (2/6/2007)
The United States Food and Drug Administration (FDA) has agreed to review a supplemental new drug application (sNDA) for the combination of Doxil (pegylated doxorubicin HCl liposome injection) in combination with Velcade (bortezomib) for the treatment of relapsed or refractory multiple myeloma.
Erythropoietin May Improve Immune Function of Patients with Multiple Myeloma (12/4/2006)
Researchers from Israel have reported that the administration of recombinant human erythropoietin (EPO, Procrit®) improves a variety of immunologic parameters and functions in patients with multiple myeloma.
Doxil®, Oncovin®, Dexamethasone and Revlimid®: Safe and Effective for Relapsed and Refractory Multiple Myeloma (11/3/2006)
Researchers from the Cleveland Clinic have reported that 29% of patients with relapsed or refractory multiple myeloma achieve complete or near complete remissions following treatment with Doxil (pegylated doxorubicin), Oncovin (vincristine), dexamethasone and Revlimid (lenalidomide).
Velcade®, Alkeran® and Prednisone Effective for Elderly with Multiple Myeloma (9/25/2006)
A multicenter Spanish study has demonstrated that the addition of Velcade (bortezomib) to standard Alkeran (melphalan) and prednisone (MP) may improve outcomes of newly diagnosed elderly patients with multiple myeloma compared to historical controls receiving MP.
Thalomid®, Doxil® and Dexamethasone Effective in Elderly with Myeloma (9/22/2006)
Researchers from Italy have reported that a regimen of Thalomid (thalidomide), Doxil® (Caelyx® in Europe) (pegylated doxorubicin) and dexamethasone is very effective and well tolerated in elderly patients with multiple myeloma.
Thalomid® Plus Dexamethasone Superior to Dexamethasone Alone for Treatment of Multiple Myeloma (7/5/2006)
A multicenter randomized trial has determined that a regimen Thalomid (thalidomide) and dexamethasone is superior to dexamethasone alone for the initial treatment of patients with multiple myeloma. The details of this large randomized trial were presented at the 2006 meeting of the American Society of Clinical Oncology in Atlanta.
Addition of Revlimid® to Dexamethasone Improves Survival in Relapsed Multiple Myeloma (6/26/2006)
According to a phase III, multicenter, randomized, double-blind trial, the addition of Revlimid (lenalidomide) to dexamethasone improves responses, time to progression and survival when compared to dexamethasone alone in the treatment of relapsed or refractory multiple myeloma.
Thalomid®/Melphalan/Prednisone: New Reference Treatment for Newly Diagnosed Elderly Multiple Myeloma Patients? (6/13/2006)
Researchers from France have reported that the addition of Thalomid (thalidomide) to the standard melphalan/prednisone (MP) improves progression-free and overall survival compared to either MP or MEL-100 and autologous stem cell support in newly diagnosed, elderly multiple myeloma patients.
Thalomid® Approved for Treatment of Newly Diagnosed Multiple Myeloma (5/30/2006)
On May 26, 2006. the United States Food and Drug Administration (FDA) approved Thalomid (thalidomide) in combination with the steroid dexamethasone for the treatment of newly diagnosed multiple myeloma.
Autologous Stem Cell Transplants Tolerated by Elderly Patients with NHL or Multiple Myeloma (5/3/2006)
Two recent articles published in Bone Marrow Transplantation suggest that advanced age alone should not be a limiting factor for treatment of non-Hodgkin’s lymphoma (NHL) or multiple myeloma with autologous stem cell transplantation.
Prevalence of Monoclonal Gammopathy of Undetermined Significance Defined (4/5/2006)
Researchers from the Mayo Clinic have determined that 3.2% of persons 50 years or older have monoclonal gammopathy of undetermined significance (MGUS).
U.S. Study Fails to Confirm Benefits of Autologous Stem Cell Transplantation for Myeloma (3/14/2006)
Researchers affiliated with three North American cooperative groups (SWOG, ECOG, CALGB) have reported that patients randomly allocated to receive an autologous stem cell transplant following a total body irradiation- (TBI) based regimen had similar outcomes to patients receiving a chemotherapy regimen without stem cell support.
Thalomid® in Induction Improves Response Rates in Elderly with Myeloma (3/14/2006)
An Italian multicenter randomized trial has determined that elderly patients with multiple myeloma treated with Thalomid (thalidomide) in addition to melphalan and prednisone (MP) have an improved response rate and delayed time to relapse compared to patients receiving MP alone.
Thalomid® Not Associated with Survival Improvement in Multiple Myeloma (3/13/2006)
Researchers from the University of Arkansas have reported that the addition of thalidomide to autologous stem cell transplantation does not improve survival for patients with newly diagnosed multiple myeloma.
Doxil® in the VAD Regimen for Myeloma Confirmed Less Toxic Than Adriamycin® (2/28/2006)
A U.S. multicenter trial has reported that a regimen of Doxil (pegylated liposomal doxorubicin), vincristine and dexamethasone is associated with less toxicity than the conventional Adriamycin- (doxorubicin) based (VAD) induction regimen for multiple myeloma.
Updated Results: Velcade® Improves Survival Over Dexamethasone in Recurrent Multiple Myeloma (2/8/2006)
Researchers affiliated with the Assessment of Proteosome Inhibition for Extending Remissions (APEX) randomized trial of Velcade (bortezomib) versus dexamethasone have reported that Velcade improves survival by approximately 6 months in recurrent multiple myeloma.
TreandaTM (Bendamustine) Plus Prednisone Superior to Melphalan Plus Prednisone for the Treatment of Multiple Myeloma (1/27/2006)
Researchers from Germany have reported that induction therapy with intravenous Treanda™ (bendamustine) plus prednisone improves the complete remission rate, prolongs time to treatment failure and improves quality of life compared to standard oral Alkeran® (melphalan) and prednisone induction therapy in patients with newly diagnosed multiple myeloma.
Tandem Autologous Transplants Compared to Autologous Followed by Reduced Intensity Allogeneic Stem Cell Transplant in Myeloma (1/16/2006)
Researchers from Italy have reported that an autologous stem cell transplant followed by a reduced intensity allogeneic stem cell transplant may be superior to tandem autologous transplants for newly diagnosed patients with multiple myeloma.
High Response Rate with Velcade™, Thalomid® and Dexamethasone for Untreated Myeloma (1/6/2006)
Researchers from M.D. Anderson Cancer Center have reported that the combination of Velcade (bortezomib), Thalomid® (thalidomide) and dexamethasone (BTD) produces complete remissions (CR) in 19% of newly diagnosed patients with multiple myeloma.
Superiority of Alkeran®, Thalomid® Prednisone Regimen for Elderly Myeloma Patients Documented (1/5/2006)
Researchers from France have concluded that a Alkeran (melphalan), prednisone, Thalomid (thalidomide) regimen was superior to a standard Alkeran-prednisone regimen or a regimen of VAD (vincristine, doxorubicin, dexamethasone) followed by mobilization of stem cells with cyclophosphamide and Neupogen® (filgrastim) and tandem transplants with Alkeran (100 mg/m2).
Low Dose of Thalomid® as Effective as Higher Dose in Relapsed Myeloma (1/4/2006)
Researchers from France have reported that 100 mg/ per day of Thalomid (thalidomide) is as effective as 400 mg per day in patients with relapsed or refractory multiple myeloma.
Velcade® Has High Activity as Initial Therapy for Multiple Myeloma (1/3/2006)
Researchers from the Salick Health Care Research Network have reported that Velcade (bortezomib) produces a 90% response rate in patients with newly diagnosed multiple myeloma.
Thalidomide Improves Initial, Not Overall Response Rate in Multiple Myeloma Following High-Dose Chemotherapy (12/29/2005)
Researchers in France have reported that induction therapy with TAD (thalidomide, doxorubicin, and dexamethasone) improves response rates compared to VAD (vincristine, doxorubicin, and dexamethasone). However, following tandem high-dose treatment, there were no differences in overall response rate between the two groups. The details of this randomized study were reported at the 47th annual meeting of the American Society of Hematology in December of 2005.
Revlimid® Plus Dexamethasone for Relapsed Multiple Myeloma Promising (12/21/2005)
Researchers affiliated with the MM-010 phase III study of Revlimid (lenalidomide) plus dexamethasone versus dexamethasone alone have reported promising results for this new agent.
Alkeran®, Prednisone and Thalomid® Highly Active for Newly Diagnosed Patients with Multiple Myeloma. (10/18/2005)
Researchers from Italy have reported that the combination of Alkeran® (melphalan), prednisone and Thalomid (thalidomide) produces a high response rate in newly diagnosed patients with multiple myeloma.
Alkeran®/Prednisone Remains Standard Therapy for Elderly Patients with Multiple Myeloma (10/4/2005)
Researchers affiliated with the Intergroupe Francophone du Myelome (IFM) have concluded that a regimen of Alkeran® (melphalan) and prednisone is preferred to dexamethasone-based regimens for patients with multiple myeloma 65 years of age or older.
Revlimid® and Dexamethasone Highly Active in Newly Diagnosed Multiple Myeloma (9/23/2005)
Researchers from the Mayo Clinic have reported a very high response rate for patients with multiple myeloma receiving induction therapy with Revlimid (lenalidomide) plus dexamethasone.
Genasense® Therapy Promising for Relapsed Myeloma (6/27/2005)
Researchers from the University of Maryland and the National Cancer Institute have reported that a regimen of Genasense (oblimersen sodium, G3139), dexamethasone and thalidomide has significant activity in patients with relapsed multiple myeloma.
Velcade® Superior to High-Dose Dexamethasone for Relapsed Myeloma (6/20/2005)
A multicenter randomized trial carried out in 93 centers in the United States, Europe, Canada and Israel and has shown that relapsed patients with multiple myeloma treated with Velcade (bortezomib) have better outcomes than those treated with high-dose dexamethasone.
Revlimid® Delays Time to Cancer Progression in Relapsed Multiple Myeloma (5/27/2005)
Results from two large phase III randomized, double-blinded, placebo-controlled trials indicate that the addition of Revlimid (lenalidomide) to high-dose dexamethasone (HDD) significantly delays time to cancer progression in patients with previously treated multiple myeloma.
Velcade® Overcomes Poor Prognosis of del(13) In Multiple Myeloma (5/18/2005)
According to results recently presented at the 2005 annual meeting of the American Society of Clinical Oncology (ASCO), treatment with Velcade (bortezomib) may overcome the poor prognosis associated with del(13), or deletion of chromosome 13 in multiple myeloma.
Post-Transplant Thalidomide and Pamidronate of Benefit in Myeloma (5/11/2005)
Researchers from France have reported that thalidomide prolongs progression-free survival (PFS) following tandem autologous stem cell transplants for patients with multiple myeloma. The same study also demonstrated that post-transplant pamidronate decreases skeletal events.
Thalidomide Induction Superior to Vincristine-Doxorubicin-Dexamethasone for Multiple Myeloma (5/10/2005)
Researchers from Italy have reported that thalidomide and dexamethasone results in a higher response rate than vincristine-doxorubicin-dexamethasone (VAD) for induction therapy of newly diagnosed multiple myeloma.
Revlimid™ Promising for Treatment of Multiple Myeloma (5/4/2005)
Celgene has announced that the results of two clinical trials of Revlimid™ (lenalidomide) for treatment of multiple myeloma will be presented at the 10th International Workshop on Multiple Myeloma in Sydney, Australia April 10-15, 2005. According to interim results, Revlimid ™ provides impressive activity in patients with multiple myeloma who have stopped responding to standard therapies.
Reduced Intensity Allogeneic Stem Cell Transplants May Not Improve Myeloma Therapy (4/14/2005)
Researchers affiliated with the European Group for Blood and Marrow Transplantation (EBMT) Chronic Leukemia Working Party have concluded that there is no evidence that reduced intensity allogeneic stem cell transplants are better than conventional myeloablative transplants. The details of this comparison were reported at the 2005 meeting of the EBMT held in Prague March 20-23, 2005.
FDA Approves Velcade® for Second Line Treatment of Myeloma (3/30/2005)
On March 25, 2005 the US Food and Drug Administration (FDA) announced the approval of Velcade® (bortezomib) for second-line therapy for patients with multiple myeloma. Velcade® was initially approved in May of 2003 for patients with myeloma who had failed two or more prior treatment regimens.
Study Confirms Effectiveness of Double Autografts in Multiple Myeloma (12/17/2004)
Researchers from Italy have reported that patients with multiple myeloma benefit from two sequential high-dose therapies if they fail to achieve a complete remission to induction and one high-dose treatment. The results of this randomized trial were presented at the 2004 meeting of the American Society of Hematology, which was held in San Diego, December 4-7.
Thalidomide is Effective Maintenance after Double Autografts for Multiple Myeloma (12/15/2004)
Researchers from France presented data that suggests that thalidomide (Thalomid®) is an effective post-transplant maintenance agent for the treatment of multiple myeloma. The results of this randomized trial were presented at the 2004 meeting of the American Society of Hematology in San Diego December 4-7.
Prophylactic Low Molecular Weight Heparin May Decrease Thalidomide-Induced Deep Vein Thrombosis (8/31/2004)
Intermediate-Dose Melphalan Improves Survival of 50-70 Year Old Myeloma Patients (8/17/2004)
Researchers from Italy have reported that 2 courses of intermediate-dose melphalan (100 mg/m2) supported by autologous stem cells improves survival of newly diagnosed patients with multiple myeloma who were 50-70 years of age compared to patients receiving standard oral melphalan and prednisone. The details of this multi-center randomized trial were pre-published online July 20, 2004 in Blood.
Randomized Trial Confirms that Neupogen® is More Effective than Leukine® for Mobilization of Peripheral Blood Stem Cells (5/20/2004)
Researchers from the University of Minnesota have reported the results of a randomized trial confirming that chemotherapy plus Neupogen® results in the collection of more stem cells than chemotherapy plus Leukine®. The details of this randomized trial appeared in the June 2004 issue of
Biology of Blood and Marrow Transplantation.
Autologous Transplants Should be Considered Early in the Course of Renal Failure in Patients with Multiple Myeloma (4/29/2004)
Researchers from the University of Arkansas have reported that a third of patients with multiple myeloma who are dialysis dependent for less than 6 months recovered renal function following autologous stem cell transplantation. The results of this study were published in the April 2004 issue of
Bone Marrow Transplantation.
IL-12 after Autologous Stem Cell Transplant Enhances Immune Recovery (4/27/2004)
Researchers from the University of Indiana reported enhanced immune reactivity in patients with lymphoid malignancies treated with autologous stem cell transplants followed by interleukin-12 (IL-12).
1 The details of this report appeared in the March 2004 issue of
Clinical Cancer Research.
Microarray Technique Identifies Molecular Basis For Osteolytic Lesions in Multiple Myeloma (12/30/2003)
Researchers from the University of Arkansas have identified an inhibitior of osteoblast differentiation which, when overexpressed in myeloma cells, is associated with osteolytic lesions. The details of this report appeared in the December 25, 2003 issue of the
New England Journal of Medicine.
1
Tandem Autologous Stem Cell Transplants Improve Survival of Patients with Multiple Myeloma (12/29/2003)
Researchers from France have reported the final analysis of a large randomized trial comparing outcomes of single versus double autologous transplants in patients with multiple myeloma. The results of this trial were presented at the 2002 meeting of the American Society of Hematology and published in the December 27, 2003 issue of the
New England Journal of Medicine.
Doxil®, Thalidomide, and Dexamethasone Improve CR Rate of Patients with Multiple Myeloma (12/16/2003)
Researchers from the Cleveland Clinic Myeloma Program reported that treatment of newly diagnosed and relapsed myeloma patients with Doxil®, Oncovin®, dexamethasone, and thalidomide (DVd-T) resulted in high response rates. The results of this phase II trial in over 100 patients was reported at the 45th annual meeting of the American Society of Hematology in December 2003.
Two Randomized Trials Fail to Show Improved Survival of Myeloma with Autologous Transplants (12/15/2003)
At the 45th annual meeting of the American Society of Hematology there were two randomized trials that failed to confirm benefit of up-front high-dose chemotherapy with autologous stem cell support compared to continued standard dose-chemotherapy in patients with newly diagnosed multiple myeloma. These results were presented in an oral session on Autologous Transplantation for Multiple Myeloma.
Sequential Auto-Allografts Promising for Patients with Myeloma Failing Initial Therapy (11/7/2003)
Researchers from the Fred Hutchinson Cancer Research Center, City of Hope National Medical Center, Stanford University, University of Colorado, the University of Leipzig, and University of Torino have reported that sequential autologous and allogeneic stem cell transplants produces complete remissions in 56% of patients with relapsed or refractory multiple myeloma. The results of this cooperative trial were published in the November 2003 issue of
Blood.
Bone Seeking Isotope is a Promising Component of High-Dose Therapy with Autologous Stem Cell Support for Multiple Myeloma (9/23/2003)
Researchers from the MD Anderson Cancer Center and the Fred Hutchinson Cancer Research Center have reported promising results of treating multiple myeloma with a high-dose regimen that includes Holmium 166 rather than total body irradiation. The results of this study appeared in the October 2003 issue of
Blood.
Systematic Review Supports Use of Bisphosphonates for Metastatic Osteolytic Cancers (8/29/2003)
Based on a meta-analysis of 30 randomized studies that evaluated bisphosphonates in patients with bone metastasis, researchers from the UK concluded that bisphosphonates decrease skeletal morbidity in patients with bone metastasis but without an improvement in survival. These results were published in the August 30, 2003 issue of the British Medical Journal.
Removal of Myeloma Cells by CD34+ Peripheral Blood Stem Cell Selection does not Improve Outcomes of Autologous Transplant (8/27/2003)
Researchers affiliated with the European Bone Marrow Transplant (EBMT) Group have reported that exclusion of myeloma cells from the peripheral blood stem cell (PBSC) graft by CD34+ stem cell selection does not improve outcomes and leads to an increased incidence of infectious complications. The results of this randomized trial were presented at the 2003 meeting of the EBMT which was held July 20-23, 2003 in Istanbul.
Cyclophosphamide, Thalidomide, Dexamethasone Regimen for Multiple Myeloma (8/18/2003)
German researchers reported a high response rate for patients with advanced multiple myeloma treated with a regimen of cyclophosphamide, thalidomide, and dexamethasone. These results were published in the August 2003 issue of the
British Journal of Haematology.
Aranesp® is Effective in Correcting Anemia in Patients with Lymphoma and Myeloma (8/12/2003)
Researchers affiliated with the Darbepoetin Alfa 20000161 Study Group reported that weekly Aranesp® administration for 12 weeks improved hemoglobin levels and decreased red blood cell transfusions in patients with lymphoma or myeloma. These findings were reported in the August 2003 issue of the
British Journal of Haematology.
Allogeneic Stem Cell Transplants for Myeloma Improved with Use of Peripheral Blood Stem Cells (5/15/2003)
Researchers from Italy have reported an apparent reduction in treatment-related mortality and improved survival in patients with multiple myeloma undergoing allogeneic peripheral blood stem cell transplants from HLA identical siblings following a myeloablative treatment regimen. These results were published in the May 1, 2003 issue of
Bone Marrow Transplantation.
FDA Announces Approval of Velcade" for Relapsed Multiple Myeloma Treatment (5/15/2003)
The US Food and Drug Administration (FDA) announced yesterday that Velcade® (bortezomib) was approved for patients with multiple myeloma who had failed two prior treatment regimens. (1) Velcade™ is the first in a new class of anticancer agents known as proteasome inhibitors. Velcade™ was approved under the FDA’s accelerated approval program.
Allogeneic Stem Cell Transplants For Multiple Myeloma (5/9/2003)
German researchers reported 2-year survivals of 25% following allogeneic transplansion for patients with multiple myeloma who have failed conventional treatment. In a subset of patients transplanted in chemosensitive relapse, the survival was over 60%. These results appeared in the May 2003 issue of the
British Journal of Haematology.
British Study Confirms Benefits of Early High-Dose Therapy for Multiple Myeloma (5/8/2003)
British researchers have reported that early high-dose chemotherapy with autologous peripheral blood stem cell support improves the complete remission (CR) rate, prolongs time to disease progression, and improves overall survival (OS) in patients with multiple myeloma. The results of this large clinical trial, involving over 400 patients, were published in the May 8, 2003 issue of the
New England Journal of Medicine.
Dexamethasone and Thalidomide Provide Effective Induction Therapy for Patients with Newly Diagnosed Multiple Myeloma (1/2/2003)
Induction therapy with Oncovin®, doxorubicin and dexamethasone (VAD), autologous stem cell harvest and high-dose chemotherapy followed by stem cell rescue is the current optimal treatment for many patients with newly diagnosed multiple myeloma. Although not curative, this strategy offers the longest reported progression-free survival and treatment related mortality is less than 5%. Previously, a regimen of Alkeran® and prednisone was considered standard treatment for patients with myeloma, but this regimen damages stem cells and makes harvesting difficult, if not impossible. Furthermore, high-dose Alkeran® is the most commonly used transplant regimen and can be given in one or two courses making initial treatment with Alkeran® less attractive. High-dose Alkeran® can be given as tandem up-front treatment or the second course can be reserved for disease progression. Both approaches appear to be better than conventional treatment without stem cell support in patients able to tolerate high-dose procedures. Although effective, the administration of VAD requires an indwelling right atrial catheter and infusional chemotherapy.
Velcade™ Promising for Multiple Myeloma (12/15/2002)
Velcade™ is a novel anticancer drug that is being evaluating in clinical trials for the treatment of patients with refractory hematologic malignancies, especially multiple myeloma. As a single agent, Velcade™ has a response rate of approximately 30% with 4-5% of these responses being complete. This is a remarkable finding since the complete remission rate by stringent criteria to first-line treatment with VAD (vincristine (Oncovin®), doxorubicin and dexamethasone) for multiple myeloma is less than 10%. For this reason, Velcade™ has been granted fast-track status by the US Food and Drug Administration for treating multiple myeloma. Velcade™ has also been evaluated in combination with thalidomide for the treatment of refractory multiple myeloma with no additive toxicities and encouraging results. Now researchers at the University of North Carolina have evaluated Velcade™ in combination with
Doxil® for the treatment of patients with refractory multiple myeloma. Interest in this combination is due to the fact that Velcade™ may block a pathway that prevents doxorubicin from killing myeloma cells. The investigators of this treatment combination presented their findings at the 2002 annual meeting of the American Society of Hematology.
Velcade™ (Bortezomib), A New Proteasome Inhibitor, Effective For Refractory Multiple Myeloma (12/15/2002)
At the 2002 meeting of the American Society of Hematology there were many presentations dealing with multiple myeloma. Over the past decade, palliative treatments for patients with multiple myeloma have improved significantly with the use of high-dose chemotherapy with autologous stem cell support and the development of thalidomide and its derivatives as effective drugs for salvage therapy. At this meeting, data on proteasome inhibitors, a new class of drugs in the treatment of multiple myeloma, was reported. The new drug that has received the most attention is Velcade™ which represents a novel potential pathway for targeted anticancer therapy. Velcade™ is a potent and selective proteasome inhibitor.
Double Autograft Improves Survival of Patients with Multiple Myeloma (12/11/2002)
Over the past decade, high-dose chemotherapy with autologous stem cell support has become standard treatment for patients with multiple myeloma under the age of 65 years. Phase II studies have strongly suggested that two courses of high-dose chemotherapy increases the complete response rate from approximately 25% to 50% with an improvement in survival. Most studies have used two up-front, high-dose treatments while other studies have reserved the second high-dose treatment for disease progression with similar overall survivals. The only randomized trial comparing a single to double autograft was performed by a French consortium of 36 medical centers. The researchers involved in this trial randomly allocated 339 patients with newly diagnosed multiple myeloma to receive a single transplant with Alkeran® and total body irradiation (TBI) or the same treatment preceded by a course of high-dose Alkeran® with stem cell support.
The Vaccine, Canvaxin, Prolongs Survival of Patients with Resected Metastatic Melanoma (12/5/2002)
Over the past two decades, there have been many attempts to treat melanoma with vaccines. The primary reason for these efforts is the belief than immune mechanisms control the spread of melanoma. For example, melanoma is one of the few cancers with a small but significant incidence of spontaneous remissions. Furthermore, a significant fraction of patients with metastatic melanoma are cured by surgery suggesting that residual cancer cells are eradicated by the body’s immune system. In most vaccine trials to date, improved outcomes have occurred entirely or predominantly in those patients who demonstrate a cellular or antibody response to the vaccine. Most vaccines have utilized killed autologous or allogeneic melanoma cells as immunogens. This has complicated vaccine trials as it is difficult to prepare large batches of consistent vaccine from this approach.
Patients with Multiple Myeloma Who Do Not Respond to Induction Can Benefit from Autologous Stem Cell Transplant (11/20/2002)
The optimal strategy for treatment of patients with multiple myeloma includes remission induction, harvesting of autologous stem cells after chemotherapy and growth factor administration, and high-dose chemotherapy followed by infusion of autologous stem cells. It is commonly thought that patients who do not respond to initial remission induction would not benefit from high-dose chemotherapy. In many centers, patients who do not achieve at least a partial remission (PR) are denied the potential benefits of high-dose chemotherapy. In addition, some insurance companies refuse to pay for high-dose treatment for patients who fail to respond to induction therapy. This issue has been addressed in the November 2002 issue of
Bone Marrow Transplantation by physicians at the Royal Marsden Hospital in England.
VAD with Pegylated Liposomal Doxorubicin (Doxil®) May Be Less Toxic for Myeloma (11/13/2002)
At the present time, the most commonly used regimen for initial treatment of patients with multiple myeloma is VAD (Oncovin®, doxorubicin and dexamethasone). The next most common approach is initial treatment with Alkeran® and prednisone with failures being treated with VAD. The treatment of choice for younger patients is VAD induction followed by autologous stem cell harvest and subsequent high-dose therapy. If stem cell harvest is planned, VAD is superior to Alkeran® as an induction strategy since it is less marrow toxic and does not interfere with stem cell harvest. Regardless of the strategy, most patients will ultimately receive VAD since none of the current treatment strategies are curative. The major disadvantage of doxorubicin is that cumulative doses can lead to heart dysfunction that is not reversible. Thus, the efficacy of VAD may be compromised and treatment is often suspended after four cycles due to cardiotoxicity. For the past decade, a form of doxorubicin,
Doxil®, has been evaluated for prevention of cardiotoxicity and to increase tumor exposure. The incorporation of doxorubicin into liposomes essentially leads to a slow release which prevents the peak exposures that are thought to be associated with cardiotoxiciy. In addition, this form of doxorubicin is thought to be less readily taken up by the myocardium.
Oral Thalidomide and Dexamethasone: Effective Initial Induction Strategy before Stem Cell Transplantation for Myeloma (11/4/2002)
Induction therapy with Oncovin®, doxorubicin and dexamethasone (VAD), autologous stem cell harvest and high-dose chemotherapy followed by stem cell rescue is the current optimal treatment for many patients with newly diagnosed multiple myeloma. Although not curative, this strategy offers the longest reported progression-free survival and treatment related mortality is less than 5%. Previously, a regimen of Alkeran® and prednisone was considered standard treatment for patients with myeloma, but this regimen damages stem cells and makes harvesting difficult, if not impossible. Furthermore, high-dose Alkeran® is the most commonly used transplant regimen and can be given in one or two courses making initial treatment with Alkeran® less attractive. High-dose Alkeran® can be given as tandem up-front treatment or the second course can be reserved for disease progression. Both approaches appear to be better than conventional treatment without stem cell support in patients able to tolerate high-dose procedures. Although effective, the administration of VAD requires an indwelling right atrial catheter and infusional chemotherapy.
New Derivative of Thalidomide, CC-5013, Shows Promise for Treatment of Myeloma (10/22/2002)
With the exception of allogeneic stem cell transplant, there are no proven curative treatments for patients with multiple myeloma. However, allogeneic stem cell transplants are limited to young individuals with suitable donors and this therapy is associated with a high treatment-related mortality. Allogeneic stem cell transplants using non-myeloablative regimens show promise but there are no long-term data to determine the ultimate utility of this approach. High-dose Alkeran® with or without autologous stem cell support probably offers the best prolongation of progression-free survival, but all patients appear to ultimately progress. Thalidomide has significant activity in patients refractory to other therapies, but has demonstrated significant side effects. These side effects include somnolence, constipation and neuropathy. Researchers at the Dana-Farber Cancer Institute have performed a phase I clinical trial of CC-5013, a derivative of thalidomide, in patients with refractory multiple myeloma. The results of this study were published in the November 2002 issue of
Blood.
Non-Myeloablative Allogeneic Stem Cell Transplants Effective in Patients Who Fail Autologous Stem Cell Transplant (10/2/2002)
High-dose chemotherapy supported by autologous stem cell transplantation is the treatment of choice for selected patients with Hodgkin’s disease, non-Hodgkin’s lymphoma and multiple myeloma. However, the majority of patients treated with autologous stem cell transplants will ultimately relapse and treatment options are few. Myeloablative regimens followed by allogeneic stem cell transplants are associated with a high treatment-related mortality due to regimen-related toxicities and graft-versus-host disease. The recent development of non-myeloablative treatment regimens followed by allogeneic stem cell transplants has been associated with less early treatment-related mortality. Researchers in England have reported that this approach is successful in half the patients who have failed a previous autologous stem cell transplant. They reported their results in the October 2002 issue of the
Journal of Clinical Oncology.
Non-Myeloablative Allogeneic Stem Cell Transplant Following Autologous Stem Cell Transplant Improves Outcome of Myeloma Patients (7/25/2002)
Over the past decade, autologous stem cell transplants have become standard therapy for younger individuals with multiple myeloma. Following autologous stem cell transplantation, up to 50% of patients achieve a complete response, but all are destined to relapse, even though they generally live longer than patients given conventional chemotherapy. Allogeneic stem cell transplants using myeloablative conditioning regimens have the potential to cure patients with multiple myeloma, but over half of patients treated this way die of transplant related complications.
The Addition of Alfa Interferon and Interleukin-2 Adds to the Palliative Effects of Chemotherapy in Patients with Metastatic Melanoma (5/7/2002)
According to results published in the
Journal of Clinical Oncology, a recent randomized trial conducted by the M.D. Anderson Cancer Center suggests that the addition of cytokines to chemotherapy improves times to cancer progression, but does not improve the cure rate for patients with advanced melanoma.
Canadians Issue Guidelines for Treatment of Multiple Myeloma with Autologous and Allogeneic Stem Cell Transplantation (5/2/2002)
Autologous stem cell transplantation has emerged as standard therapy for patients with multiple myeloma, primarily as a result of randomized trials performed in France over the past decade. The role of allogeneic stem cell transplantation, however, has been more limited and is usually applied to patients who fail an autologous transplant, who are very young, or who have very aggressive disease unlikely to respond to an autologous transplant. Recently, The Hematology Disease Site Group of the Cancer Care Ontario Practice Guidelines Initiative has developed practice guidelines assessing the role of stem cell transplantation in patients with multiple myeloma. These guidelines were published in the April 16 issue of the
Annals of Internal Medicine.
Maintenance Therapy with Alternate Day Prednisone Improves Survival of Responding Patients with Multiple Myeloma (5/1/2002)
According to results recently published in
Blood, alternate-day prednisone is effective maintenance treatment for multiple myeloma patients who achieve a response to induction chemotherapy with VAD.
Autologous Stem Cell Transplants Following High-Dose Alkeran® Alone is Superior to High-Dose Alkeran® Plus Total Body Irradiation (3/19/2002)
The outcome of patients with newly diagnosed multiple myeloma who receive high-dose therapy (HDT) followed by autologous peripheral blood stem cell transplantation is superior to that of patients receiving conventional chemotherapy. Randomized trials documenting the superiority of autologous transplants have been primarily conducted by the Intergroupe Francophone du Myélome (IFM). Their first trial prospectively compared conventional chemotherapy with HDT and autologous stem cell transplants and showed that patients treated with autologous stem cell transplants had significantly improved response rates, event-free survival and overall survival. That trial used a conditioning regimen of 8 Gy total body irradiation (TBI) plus 140 mg/m2 intravenous Alkeran®. The complete response rate after HDT was 22%, and the probability of EFS at 5 years after the diagnosis was 28%. No plateau of the survival curves was observed. However, the presence of a response to HDT was related to survival, and the 5-year probability of survival after diagnosis was 72% among patients who had complete or very good partial responses.
The FDA Approves Zometa® for the Treatment of Bone Metastases Associated with a Broad Range of Tumor Types (2/26/2002)
Zometa® (zoledronic acid) is a new generation bisphosphonate that inhibits osteoclast bone resorption. A recent study compared Zometa® to Aredia® for the treatment of skeletal metastases in patients with breast cancer or osteolytic lesions of multiple myeloma.
Rate of Progression to Malignancy Is Relatively Low for Persons with Monoclonal Gammopathy of Undetermined Significance (MGUS) (2/25/2002)
A monoclonal gammopathy of undetermined significance (MGUS) is very common and occurs in up to 2% of persons 50 years of age or older and 3% of those older than age 70 years. MGUS has been defined by the presence of serum monoclonal protein at a concentration of 3 g per deciliter or less; no monoclonal protein or only moderate amounts of monoclonal light chains in the urine; the absence of lytic bone lesions, anemia, hypercalcemia and renal insufficiency related to the monoclonal protein and a proportion of plasma cells in the bone marrow of 10% or less. It has been speculated that MGUS inevitably leads to malignancy but reliable estimates on rates of progression have not been identified with any accuracy.
Autologous Stem Cell Transplant Following High-Dose Alkeran® Alone is Superior to High-Dose Alkeran® Plus Total Body Irradiation (2/19/2002)
The outcome of patients with newly diagnosed multiple myeloma who receive high-dose therapy (HDT) followed by autologous peripheral blood stem cell transplantation is superior to that of patients receiving conventional chemotherapy. Randomized trials documenting the superiority of autologous transplants have been performed primarily by the Intergroupe Francophone du Myélome (IFM). Their first trial prospectively compared conventional chemotherapy with HDT and autologous stem cell transplants and showed that patients treated with autologous stem cell transplants had significantly improved response rates, event-free survival and overall survival. That trial used a conditioning regimen of 8 Gy total body irradiation (TBI) plus 140 mg/m2 intravenous Alkeran® (melphalan). The complete response rate after HDT was 22%, and the probability of EFS at 5 years after the diagnosis was 28%. No plateau of the survival curves was observed. However, the presence of a response to HDT was related to survival, and the 5-year probability of survival after diagnosis was 72% among patients who had complete or very good partial responses.
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