Title: Study of Clinical Profile of Multiple Myeloma and Impact of Novel Therapies on Quality of Life

Authors: Shruthi Vitalarao Kulkarni, Sunanda Amonkar

 DOI: https://dx.doi.org/10.18535/jmscr/v8i12.19

Abstract

Multiple myeloma is one of the common plasma cell dyscrasia. it has heterogenous clinical presentation, and it can involve multiple organs. Its prevalence is more common in males than in females, and in black population. Etiology of multiple myeloma include radiation exposure, exposure to variety of carcinogens, chronic antigenic stimulation, autoimmunity.

There has been a significant change in treatment modality of multiple myeloma. The median survival of multiple myeloma patients was less than a year before the introduction of alkylating agents. Introduction of Melphalan, high-dose chemotherapy and stem cell have demonstrated a survival advantage compared with patients undergoing conventional chemotherapy. The introduction of Thalidomide was a major milestone in the treatment of multiple myeloma, and its analog Lenalidomide and the proteasome inhibitor Bortezomib have expanded the therapeutic spectrum for multiple myeloma. With development of newer chemotherapy regimens, quality of life has improved, but at the same time these newer regimens are associated with specific side effects.

Keywords: Multiple myeloma, staging, electrophoresis, chemotherapy, relapse.

References

  1. Hematology, C. Wintrobe’s Clinical Hematology.
  2. Cömert, M., Güneş, A. E., Şahin, F. & Saydam, G. Multiple myeloma dayaamkalitesivedestektedavisi. Turkish J. Hematol. 30, 234–246 (2013).
  3. Dex, R. E. V et al. Combination therapy with lenalidomide plus dexamethasone (rev/dex) for newly diagnosed myeloma. (2005). doi:10.1182/blood-2005-07-2817
  4. Ttal, M. I. A., Arousseau, J. E. A. N. U. C. H., Toppa, A. N. N. E. A. S. & Otto, J. E. A. N. A. S. A Prospective, Randomized Trial Of Autologous Bone Marrow Transplantation And Chemotherapy In Multiple Myeloma. 91–97 (1996).
  5. Myeloma, N. D. Newly Diagnosed Myeloma.
  6. Palumbo, A. NIH Public Access. 112, 1522–1528 (2009).
  7. Dimopoulos MA, Anagnostopoulos A, Weber D. Treatment of plasma cell dyscrasias with thalidomide and its derivatives. J Clin Oncol. 2003;21:4444–4454.
  8. Field-smith, A. Bortezomib (VelcadeTM) in the treatment of multiple myeloma. 2, 271–279 (2006)
  9. Richardson PG, Blood E, Mitsiades CS, et al. A randomized phase 2 study of lenalidomide therapy for patients with relapsed or relapsed and refractory multiple myeloma Blood. 2006;108:3458–3464.
  10. Rajkumar SV, Hayman SR, Lacy MQ, et al. Combination therapy with lenalidomide plus dexamethasone (Rev/Dex) for newly diagnosed myeloma. Blood. 2005;106: 4050–4053.
  11. Dimopoulos M, Spencer A, Attal M, et al. Lenalidomide plus dexamethasone for relapsed or refractory multiple myeloma . N Engl J Med. 2007;357:2123–2132.
  12. Weber DM, Chen C, Niesvizky R, et al. Lenalidomide plus dexamethasone for relapsed multiple myeloma in North America. N Engl J Med. 2007;357:2133–2142.
  13. Boccadoro M, Palumbo A. New developments and treatment in multiple myeloma: New drugs in the treatment of multiple myeloma. Ann Oncol. 2002;13(SUPPL. 4):55–8.
  14. Major P, Lortholary A, Hon J et al. Zoledronic acid is superior to pamidronate in the treatment of hypercalcemia of malignancy: a pooled analysis of two randomized, controlled clinical trials. J Clin Oncol 2001; 19: 558–567.
  15. Berenson JR, Lichtenstein A, Porter L et al. Efficacy of pamidronate in reducing skeletal events in patients with advanced multiple myeloma. Myeloma Aredia Study Group. N Engl J Med 1996; 334: 488–493.
  16. Rosen LS. Zoledronic acid versus pamidronate in the treatment of skeletal metastases in patients with breast cancer or osteolytic lesions of multiple myeloma : a phase III, doubleblind, comparative trial. Cancer J 2001; 7: 377–387.
  17. Khalil Al-Farsi et al, Oman Medical Journal (2013) Vol. 28, No. 1:3-11
  18. Kyle RA, Therneau TM, Rajkumar SV, Larson DR, Plevak MF, Melton LJ III. Incidence of multiple myeloma in Olmsted County, Minnesota: trend over 6 decades. Cancer. 2004;101:2667-2674.
  19. Lewis DR, Pottern LM, Brown LM, et al. Multiple myeloma among blacks and whites in the United States: the role of chronicantigenic stimulation. Cancer Causes Control. 1994;5:529-539.
  20. Abergel, R. & Gross, E. www.aging ‐ us.com AGING 2017 Vol. 9, No. 11. 9, 2241–2242 (2017).
  21. Athira et al. Clinical Profile Of Multiple Myeloma At GRH – Madurai 2005 – 2007
  22. Article, O. Patterns of Multiple Myeloma During the Past 5 Decades: Stable Incidence Rates for All Age Groups in the Population but Rapidly Changing Age Distribution in the Clinic. 225–230 (2010). doi:10.4065/mcp.2009.0426
  23. Gerecke, C. et al. The Diagnosis and Treatment of Multiple Myeloma. 470–477 (2016). doi:10.3238/arztebl.2016.0470S
  24. Naryan, R. & Ali, M. Clinical Profile of Multiple Myeloma in South India. 62–66 (2018). doi:10.4103/ijmpo.ijmpo

Corresponding Author

Shruthi Vitalarao Kulkarni

Senior Resident, Dept. of General Medicine