Aktualne podejścia terapeutyczne w szpiczaku plazmocytowym

Maria Kraj

Summary
Conventional dose chemotherapy is a fundamental therapeutic approach in multiple myeloma. High-dose chemotherapy with autologous hematopoietic cell transplantation may be offered to patients up to the age of 70 years and treatment related mortality does not exceed 5%. Still unresolved remains the critical question whether early high-dose intensification with autotransplantation has the advantage over continuation of conventional chemotherapy in patients responding to initial treatment. Transplantation of allogeneic hematopoietic cells gives long survivals but relapses occur and the problem is a high treatment – related mortality. This is the reason that this method of treatment may be taken into consideration only in selected patients at age below 55 years with poor prognostic factors. Interferon maintenance treatment prolongs remission duration particularly in patients after autologous stem cell transplantation. Preliminary studies suggest that thalidomide, known to exhibit anti-angiogenic properties, also exhibits antitumor activity similar to that noted with pulse dexamethasone and superior to that noted with interferon in refractory and relapsed myeloma.

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