Myeloma multiplex treatment and overall survival
Journal
Macedonian pharmaceutical bulletin
Date Issued
2021-11
Author(s)
Popova-Labachevska, Marija
Kalchev, Goce
DOI
10.33320/maced.pharm.bull.2021.67.01.008
Abstract
The Multiple myeloma (MM) is a plasma cell malignancy in which monoclonal plasma cells proliferate in bone marrow, resulting in
an overabundance of monoclonal paraprotein (M protein), destruction of bone, and displacement of other hematopoietic cell lines.
This retrospective-prospective study was conducted at the University Clinic for Hematology in Skopje, North Macedonia, in the
period between January 2009 and December 2019. Patients younger than 65 years, without comorbidities, fit for autologous peripheral
blood stem cell transplantation (PBSCT), were treated with Cyclophosphamide-Thalidomide-Dexamethasone (CyThalDex) protocol
divided into two daily doses which were maintained until complete remission. Patients over 65 years of age, unfit for more aggressive
treatment options like peripheral blood stem cells (PBSCT) with comorbidities and renal failure, were treated with MelphalanPrednisone-Thalidomide (MPT) protocol. The third group of patients was treated without new immunomodulators such as thalidomide,
but instead a salvage therapy was given consisted of chemotherapy and corticosteroids.
The use of thalidomide can lead to more undesirable effects such as deep vein thrombosis and renal neuropathy. The results obtained
in our study showed no high percentage of these effects. However, a better survival rate was registered along with a longer period
without progression of the underlying disease (PFS). Moreover, a higher percentage of complete remission (CR) was achieved and a very
good partial response (VGPR) in general.
Myeloma multiplex is still incurable disease with pattern of regression and remission followed by multiple relapses rising from the
residual myeloma cells, but in the future still many unsolved questions has to be answered
an overabundance of monoclonal paraprotein (M protein), destruction of bone, and displacement of other hematopoietic cell lines.
This retrospective-prospective study was conducted at the University Clinic for Hematology in Skopje, North Macedonia, in the
period between January 2009 and December 2019. Patients younger than 65 years, without comorbidities, fit for autologous peripheral
blood stem cell transplantation (PBSCT), were treated with Cyclophosphamide-Thalidomide-Dexamethasone (CyThalDex) protocol
divided into two daily doses which were maintained until complete remission. Patients over 65 years of age, unfit for more aggressive
treatment options like peripheral blood stem cells (PBSCT) with comorbidities and renal failure, were treated with MelphalanPrednisone-Thalidomide (MPT) protocol. The third group of patients was treated without new immunomodulators such as thalidomide,
but instead a salvage therapy was given consisted of chemotherapy and corticosteroids.
The use of thalidomide can lead to more undesirable effects such as deep vein thrombosis and renal neuropathy. The results obtained
in our study showed no high percentage of these effects. However, a better survival rate was registered along with a longer period
without progression of the underlying disease (PFS). Moreover, a higher percentage of complete remission (CR) was achieved and a very
good partial response (VGPR) in general.
Myeloma multiplex is still incurable disease with pattern of regression and remission followed by multiple relapses rising from the
residual myeloma cells, but in the future still many unsolved questions has to be answered
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