TY - JOUR
T1 - Biology and treatment of myeloma
AU - Greipp, Philip R.
AU - Witzig, Thomas
PY - 1996
Y1 - 1996
N2 - New strategies for the treatment of multiple myeloma, particularly high- dose therapy with peripheral blood stem cell transplantation, can achieve complete response in up to 50% of cases. The patient's condition eventually relapses because transplantation does not completely eliminate myeloma. Posttreatment interferon may prolong responses achieved by transplantation or chemotherapy, but it does not necessarily prolong survival. New approaches are being developed to further eliminate myeloma cells after an incomplete response achieved by transplantation or other chemotherapy. These approaches aim at myeloma cell surface antigens, T-cell immunity, and biological mechanisms of myeloma growth and dissemination. Biological targets include interleukin-6 (the central myeloma growth factor), interleukin-1β (an amplifier of stromal and bone cell production of interleukin-6), and serum soluble interleukin-6 receptor (an enhancer of myeloma cell response to interleukin 6). Efforts to eliminate circulating myeloma cells from peripheral blood stem cell harvests use positive selection or purging to provide a product that will engraft only normal stem cells, not myeloma cells. Multidrug resistance, a major factor in treatment failure, can be reversed by agents that inhibit the multidrug resistance protein on the myeloma cell surface. Finally, expanded knowledge of biologic mechanisms has led to the development of new prognostic factors. These aim to identify patients in clinical trials who can benefit from treatment regimens designed to overcome their impact on survival. Translating new biological advances into treatment programs is essential to improving therapy for patients with myeloma.
AB - New strategies for the treatment of multiple myeloma, particularly high- dose therapy with peripheral blood stem cell transplantation, can achieve complete response in up to 50% of cases. The patient's condition eventually relapses because transplantation does not completely eliminate myeloma. Posttreatment interferon may prolong responses achieved by transplantation or chemotherapy, but it does not necessarily prolong survival. New approaches are being developed to further eliminate myeloma cells after an incomplete response achieved by transplantation or other chemotherapy. These approaches aim at myeloma cell surface antigens, T-cell immunity, and biological mechanisms of myeloma growth and dissemination. Biological targets include interleukin-6 (the central myeloma growth factor), interleukin-1β (an amplifier of stromal and bone cell production of interleukin-6), and serum soluble interleukin-6 receptor (an enhancer of myeloma cell response to interleukin 6). Efforts to eliminate circulating myeloma cells from peripheral blood stem cell harvests use positive selection or purging to provide a product that will engraft only normal stem cells, not myeloma cells. Multidrug resistance, a major factor in treatment failure, can be reversed by agents that inhibit the multidrug resistance protein on the myeloma cell surface. Finally, expanded knowledge of biologic mechanisms has led to the development of new prognostic factors. These aim to identify patients in clinical trials who can benefit from treatment regimens designed to overcome their impact on survival. Translating new biological advances into treatment programs is essential to improving therapy for patients with myeloma.
UR - http://www.scopus.com/inward/record.url?scp=0029988814&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0029988814&partnerID=8YFLogxK
U2 - 10.1097/00001622-199601000-00004
DO - 10.1097/00001622-199601000-00004
M3 - Review article
C2 - 8868095
AN - SCOPUS:0029988814
SN - 1040-8746
VL - 8
SP - 20
EP - 27
JO - Current Opinion in Oncology
JF - Current Opinion in Oncology
IS - 1
ER -