International Journal of Myeloma
Online ISSN : 2187-3143
Volume 3, Issue 1
Displaying 1-6 of 6 articles from this issue
EDITRIAL
REVIEW
  • Masahiro ABE
    Article type: REVIEW
    2013 Volume 3 Issue 1 Pages 2-11
    Published: 2013
    Released on J-STAGE: August 10, 2022
    JOURNAL FREE ACCESS

    Bone provides a unique microenvironment for myeloma (MM) cell growth and survival, including niches to foster clonogenic MM cells. MM cells stimulate bone resorption by enhancing osteoclastogenesis, while suppressing bone formation by inhibiting osteoblastic differentiation from bone marrow stromal cells, leading to extensive bone destruction with rapid loss of bone. MM cells alter the microenvironment through bone destruction in bone where they colonize, which in turn favors tumor growth and survival, thereby forming a vicious cycle between tumor ­progression and bone destruction. MM is still difficult to be cured despite the recent implementation of new agents, and its bone disease also remains a significant clinical problem. Further elucidation of the molecular mechanisms of tumor-bone interactions and tumor growth in the bone microenvironment will provide us with new approaches that have a real impact on both bone disease and tumor progression.

    Download PDF (428K)
  • Tadao ISHIDA
    Article type: 総  説
    2013 Volume 3 Issue 1 Pages 12-25
    Published: 2013
    Released on J-STAGE: August 10, 2022
    JOURNAL FREE ACCESS

    More than thirty years, the combination melphalan-prednisone (MP) has been considered the standard treatment for the transplant-ineligible multiple myeloma patients. In the last decade, the emergence of novel agents, such as thalidomide, lenalidomide and bortezomib, has increased the treatment options. In VISTA trial, MP pulse bortezomib (MPB) was correlated with an increase in both TTP and OS compared with MP. From the six randomized controlled trials compared MP and MP pulse thalidomide (MPT), the meta-analysis has demonstrated that MPT result in improved PFS and OS. MPB and MPT currently appear to be the new standards of care, but other combination of lenalidomide and dexamethasone could provide good options. And recently, FDA has approved carfilzomib and pomalidomide. These new drugs are also very effective for the multiple myeloma patients. Farther more, a lot of phase II and phase III trials have demonstrated the efficacy of novel agents combinations, and based on these results new standard frontline regimens are being challenged.

    Download PDF (1722K)
  • Hiroshi HANDA
    Article type: 総  説
    2013 Volume 3 Issue 1 Pages 26-34
    Published: 2013
    Released on J-STAGE: August 10, 2022
    JOURNAL FREE ACCESS

    In recent years, the overall survival of multiple myeloma patients has extended by the improvement of the treatment including novel agents, but such extension is not enough for the elderly patients. In this report, I discuss what should be considered to provide optimal treatment of vulnerable elderly myeloma patients. Twenty six percent of the newly diagnosed patients are aged 65–74 years old, 37% are more than 75 years old, so it is apparent that this disease is for elderly people. Elderly people are various than younger people and a gap exists between chronological age and biological age. European Myeloma Network proposed how to choose therapy and drug dose considering vulnerability, comorbidity, disability and frailty. Overall survival is extended even in the elderly patients who achieved CR by the therapy incorporating novel agents. However, appropriate dose reduction should be taken because of reduced organs function. The QOL score of myeloma patients before treatment is quite low, and the score is improved by chemotherapy. But attention is necessary because QOL score temporarily turns worse by a sort of novel agents.

    Download PDF (967K)
  • Ichiro HANAMURA, Shinsuke IIDA, Masafumi TANIWAKI
    Article type: 総  説
    2013 Volume 3 Issue 1 Pages 35-46
    Published: 2013
    Released on J-STAGE: August 10, 2022
    JOURNAL FREE ACCESS

    Multiple myeloma is a neoplasm of plasma cells, which evolves from monoclonal gammopathy of undeter­mined significance (MGUS) to aggressive disease by acquiring a series of mutations. Translocations involving the immunoglobulin loci are important for the pathogenesis of myelomagenesis, and the sequential acquisition of additional genetic aberrations and epigenetic changes can lead to disease progression. Recent progress in genome-wide sequencing studies revealed new and unexpected oncogenic mechanisms in myeloma, including the mutations of genes involved in protein translation and histone methylation as well as intratumor heterogeneity. A better understanding of the molecular pathogenesis of this disease is fundamental to developing targeted therapies and better prognostic models. Here we review the current understanding of myeloma pathogenesis for more effective treatment strategies.

    Download PDF (889K)
  • Tsuyoshi Muta, Tomohiko Kamimura, Toshihiro Miyamoto, Yuju Ohno, Tomok ...
    Article type: 原  著
    2013 Volume 3 Issue 1 Pages 47-54
    Published: 2013
    Released on J-STAGE: August 10, 2022
    JOURNAL FREE ACCESS

    Introduction: We performed a retrospective analysis to elucidate the effectiveness of tandem autologous hematopoietic stem cell transplantation (auto-SCT) using high dose melphalan for patients with multiple myeloma. Patients and methods: Between October 2001 and August 2011, 53 patients underwent single auto-SCT (singled group) and 49 patients underwent tandem auto-SCT (tandem group) in FBMTG. Conventional chemotherapy was used for the majority patients as induction. The hematopoietic stem cells were mobilized by either cytotoxic chemotherapy or granulocyte colony-stimulating factor alone. Results: The disease status at presentation was compared between the two groups. 5 year overall survival (OS) from the SCT (single 46% vs. tandem 62%, P = 0.007) and 3 year progression free survival (PFS) (single 27% vs. tandem 41%, P = 0.02) were superior in the tandem group. Two patients died due to sepsis early during the first auto-SCT. The incidence of herpes zoster seems to be higher after tandem auto-SCT (2% vs. 20%, P = 0.003). Conclusions: The results of tandem auto-SCT revealed promising, but the current study is a retrospective manner, and selection bias seems to affect the consequence. Accordingly, we couldn’t conclude the superiority of tandem over single, which should be clarified in the future.

    Download PDF (496K)
feedback
Top