Targeting the Pathogenic Role of Interleukin 1β in the Progression of Smoldering/Indolent Myeloma to Active Disease

摘要: The article by Lust et al1 published in this issue of Mayo Clinic Proceedings is the first study to address a purely cytokine-driven pathogenic mechanism progression from premalignant state multiple myeloma active disease. working hypothesis that plasma cell-derived interleukin 1 (IL-1) β induces marrow stromal cells produce large amounts 6 (IL-6), thereby promoting survival and expansion cells. 47 patients with smoldering or indolent (SMM/IMM) enrolled were clearly at high risk full-blown on basis well-established criteria.2 For reduction IL-1β activity, trial used anakinra, recombinant form naturally occurring receptor antagonist (IL-1Ra) for treatment rheumatoid arthritis autoinflammatory diseases.3 results al suggest reducing activity does, fact, significantly increase progression-free (PFS) these high-risk patients. thoroughly encouraging because long-term use anakinra safe. combination plus low dose dexamethasone provided best outcomes. There may be hidden benefit patients; potent, proangiogenic cytokine,4 and, compared thalidomide, essentially free toxic adverse effects. A National Institutes Health as an antiangiogenic therapy cutaneous melanoma ongoing.