Management of patients with multiple myeloma: emphasizing the role of high-dose therapy.

摘要: Abstract Treatment for multiple myeloma should not be given until the patient is symptomatic or at risk occurrence of complications disease. If younger than 70 years, physician seriously consider an autologous peripheral blood stem cell transplant. Most physicians initially administer vincristine/doxorubicin/dexamethasone (VAD) 3 to 4 months and then collect cells before exposure alkylating agents. Following collection, one may proceed with high-dose chemotherapy infusion cells, can agents a plateau reached delay transplantation progressive disease occurs. There no difference in overall survival between early late transplantation, but former avoids cost inconvenience agent therapy. Double tandem transplants produce better results, evidence strong. Almost all patients have relapse after transplant, so efforts are being made prolong response α2-interferon dendritic Allogeneic bone marrow feasible only 5%–10% patients, mortality high it curative small fraction patients. melphalan prednisone results objective 50%–60% Combinations higher rate, there benefit. Thalidomide produces about third refractory It currently studied conjunction dexamethasone conventional initial