Abstract
Multiple myeloma (MM) is a malignant disease of the plasma cells representing approximately 10% of all hemato-oncological diseases. Detection of the disease is most probable at around 65 years of age, and the average survival of patients is estimated to be 5–10 years, specifically due to frequent relapses and resistance to the therapy used. Thus, the search for new therapeutic approaches is becoming a big challenge. Disulfiram (DSF), a substance primarily known as a medication against alcoholism, has often been mentioned in recent years in relation to cancer treatment for its secondary anti-cancer effects. Recent studies performed on myeloma cell lines confirm high inhibition of the cell growth activity if a complex of disulfiram and copper is used. Its significant potential is now being seen in the cure of haematological malignities.
Highlights
In the pathogenesis of MM, development of the malignant clone is influenced by genetic change; the interaction between malignant plasma cells and the microenvironment of the bone marrow is of the same importance for the survival and further progression of myeloma cells
This review supports the importance of repurposing disulfiram as a potential anticancer agent in scientific and follow-up clinical trials, focusing on multiple myeloma treatment
Because the new treatment options are targeted at patients with relapsed multiple myeloma, disulfiram appears to be effective in treating this disease stage
Summary
Multiple myeloma is a disease of terminally differentiated B lymphocytes with the subsequent formation of malignant plasma cells, excessively producing monoclonal immunoglobulin, the so called M-protein [1]. The first precursor stage is monoclonal gammopathy of undetermined significance (MGUS), accompanied by a low blood level of the M-protein as well as the number of clonal plasma cells in the bone marrow being under 10%, where the risk of transition from MGUS to active myeloma is only 1% [3]. The stage of the disease is called smouldering myeloma (SMM), when a higher blood level of the M-protein can be detected and the number of clonal plasma cells is rising (10–20%). The signs of malignant character include the presence of nuclear inclusions (so called Dutcher bodies) and multinucleated cells Another important indicator for stating the diagnosis of MM is the assessment of individual light chain concentrations as well as determination of the abnormality of their ratio. Cytostatic drugs, steroids, and interferon, as well as thalidomide, have been tested; most have been abandoned due to significant adverse effects and insufficient efficiency in some cases [10]
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