1. Therapeutic management of hematological malignancies in elderly patients. Biological and clinical considerations. Part IV: Multiple myeloma and Waldenström's macroglobulinemia.
- Author
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Quaglino D, Di Leonardo G, Pasqualoni E, Furia N, and Di Simone S
- Subjects
- Antineoplastic Agents, Alkylating therapeutic use, Antineoplastic Agents, Hormonal therapeutic use, Diagnosis, Differential, Drug Therapy, Combination, Humans, Melphalan therapeutic use, Multiple Myeloma diagnosis, Prednisone therapeutic use, Waldenstrom Macroglobulinemia diagnosis, Aging physiology, Hematologic Diseases therapy, Multiple Myeloma therapy, Waldenstrom Macroglobulinemia therapy
- Abstract
Following recent data on multiple myeloma (MM) in the literature, a possible model of myeloma development, involving different cytokine signals, is advanced, and the prognostic significance of two principle staging systems is evaluated. Different therapeutic approaches to MM have been employed, consisting of either treatment with only melphalan and prednisone, or combination chemotherapy, especially in patients with a poor prognosis. However, for the initial therapy, melphalan plus prednisone in doses that compensate for individual variation in drug absorption still appears the best choice in the vast majority of MM patients. The main clinical and hematological features which distinguish Waldenström's macroglobulinemia from MM are described, as are the criteria which should be used in choosing the most appropriate treatment based, when necessary, on chemotherapy with standard alkylating agents, as well as on the new nucleoside analogues, and repeated courses of plasmapheresis.
- Published
- 1998
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