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 Melphalan-Prednisone-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. Keywords: myeloma multiplex, autologous stem cell transplantation, thalidomide
Highlights
It is a genetically complex disease which develops via multistep process whereby plasma cells are drivenS
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
Younger than 65 years, without comorbidities, fit for autologous PBSCT, were treated with Cyclophosphamide-Thalidomide-Dexamethasone (CyThalDex) protocol divided into two daily doses which were maintained until complete remission
Summary
It is a genetically complex disease which develops via multistep process whereby plasma cells are driven. Panovska Stavridis towards malignancy through the accumulation of genetic “hits” over time. Almost all patents with monoclonal gammopathy could be diagnosed as symptomatic or asymptomatic (Morgan et al, 2012). Multiple myeloma (MM) evolves from an antecedent asymptomatic monoclonal gammopathy of undetermined significance (MGUS). Patients with a symptomatic disease should be treated immediately, whereas asymptomatic disease is subject of additional observation (van de Donk et al, 2016)
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
