Abstract
High-dose therapy with the rescue of autologous stem cells represents today the standard approach for multiple myeloma patients aged < 65 years. Several studies, in fact, have demonstrated the superiority of high-dose therapy with respect to conventional chemotherapy in younger patients. Peripheral blood stem cells (PBSCs) provide a rapid and effective hematopoietic recovery after the administration of supra maximal chemotherapy and mainly for this reason have become the preferred source of stem cells for autologous transplantation. Recently, however, a number of new drugs have appeared in the armamentarium of the hematologist. Among these, thalidomide has been the first antiangiogenetic drug effectively adopted firstly in refractory-relapsed patients and now also as first line treatment with better results respect to VAD or VAD-like regimens. Inhibitors of proteasome, such as bortezomib, and other immunomodulatory agents, such as lenalidomide, have been also studied more recently in myeloma patients. In particular, bortezomib has shown to be very effective as single agent or in combination with high-dose dexamethasone. In this review, we try to define the potential role of these new drugs, how and when they can be included in the therapeutic program designed for younger and older patients, and mostly if and how these new agents could jeopardize the central role of autologous stem cell transplantation in the treatment of multiple myeloma.
Keywords: Thalidomide, Lenalidomide, Bortezomib, Chemotherapy, Transplantation
Current Stem Cell Research & Therapy
Title: The Impact of New Emerging Drugs in the Treatment of Multiple Myeloma:Is there Still a Role for PBSC Transplantation?
Volume: 2 Issue: 1
Author(s): Alessandro Corso and Marzia Varettoni
Affiliation:
Keywords: Thalidomide, Lenalidomide, Bortezomib, Chemotherapy, Transplantation
Abstract: High-dose therapy with the rescue of autologous stem cells represents today the standard approach for multiple myeloma patients aged < 65 years. Several studies, in fact, have demonstrated the superiority of high-dose therapy with respect to conventional chemotherapy in younger patients. Peripheral blood stem cells (PBSCs) provide a rapid and effective hematopoietic recovery after the administration of supra maximal chemotherapy and mainly for this reason have become the preferred source of stem cells for autologous transplantation. Recently, however, a number of new drugs have appeared in the armamentarium of the hematologist. Among these, thalidomide has been the first antiangiogenetic drug effectively adopted firstly in refractory-relapsed patients and now also as first line treatment with better results respect to VAD or VAD-like regimens. Inhibitors of proteasome, such as bortezomib, and other immunomodulatory agents, such as lenalidomide, have been also studied more recently in myeloma patients. In particular, bortezomib has shown to be very effective as single agent or in combination with high-dose dexamethasone. In this review, we try to define the potential role of these new drugs, how and when they can be included in the therapeutic program designed for younger and older patients, and mostly if and how these new agents could jeopardize the central role of autologous stem cell transplantation in the treatment of multiple myeloma.
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Cite this article as:
Corso Alessandro and Varettoni Marzia, The Impact of New Emerging Drugs in the Treatment of Multiple Myeloma:Is there Still a Role for PBSC Transplantation?, Current Stem Cell Research & Therapy 2007; 2 (1) . https://dx.doi.org/10.2174/157488807779316955
DOI https://dx.doi.org/10.2174/157488807779316955 |
Print ISSN 1574-888X |
Publisher Name Bentham Science Publisher |
Online ISSN 2212-3946 |
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