MYELOMA - DRUGS FOR THE TREATMENT OF MULTIPLE MYELOMA

Definition

Of all blood-related neoplasms, multiple myeloma constitutes 10-15%: it has been observed that the incidence of cancer tends to increase exponentially with advancing age. We are talking about a tumor sustained by the uncontrolled proliferation of cells belonging to the immune system, mainly used for the production of antibodies.

Causes

Myeloma is the result of an unregulated overproduction of plasma cells in the bone marrow: according to this, we understand how multiple myeloma has an oncological basis. However, the main triggers are still being studied. Among the risk factors we cannot forget: frequent contact / inhalation of pesticides / insecticides / benzene, ionizing radiation, old age, belonging to the Caucasian population.

Symptoms

The symptoms that characterize myeloma are very varied, as they depend on the anatomical site affected and the severity of the neoplasm: anemia, asthenia, joint pain, recurrent infections, renal failure, hypercalcemia and neuropathy. In the vast majority of cases, the diagnosis is completely random.

The information on Myeloma - Multiple Myeloma Treatment Drugs is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Myeloma - Multiple Myeloma Drugs.

Medicines

As is the case with many cancers, the symptoms of myeloma are often vague and vague, so much so that they are confused with other pathologies. All this leads to a diagnostic delay, therefore postponing the treatment also decreases the chances of complete recovery.
In the past, radiotherapy, the use of cortisone drugs and the use of anesthetics with alkylating properties (eg ethyl urethane) represented the three first-line therapeutic strategies for the treatment of myeloma. Although unfortunately it remains an incurable disease, currently multiple myeloma is generally treated with chemotherapy drugs, useful for relieving painful symptoms and improving the patient's life expectancy.
In young people with multiple myeloma, chemotherapy generally follows bone marrow transplant (from HLA-compatible family donor); however, even this procedure does not seem to be entirely effective in definitively curing the disease.

The following are the classes of anticancer drugs most used in therapy against myeloma, and some examples of pharmacological specialties; it is up to the doctor to choose the most suitable active ingredient and dosage for the patient, based on the severity of the disease, the state of health of the patient and his response to treatment:

Melphalan (eg. Alkeran, tablets or solution for injection): the administration of this drug (alkylating agent) is generally supported by haematopoietic stem cells (transplant): this procedure represents the standard treatment for all myeloma patients of older age. over 70 years old. In older patients, transplantation is not recommended; it is preferred to associate this drug with glucocorticoids (eg prednisone: eg. Deltacortene, Lodotra).

Bortezomib (eg Velcade): this is an anticancer drug indicated to treat both early and advanced stage multiple myeloma. The active ingredient is administered by intravenous injection at an initial dose of 1.3 mg / m2 of body surface area, over 3-5 seconds, by means of a catheter. The drug can be administered in combination with glucocoticids and melphalan: in this case, the dosage is 1.3 mg / m2, to be taken twice a week, in the first, second, fourth and fifth week of treatment, in a cycle of 6 weeks. Repeat this method of administration three times.

Doxorubicin Hydrochloride (eg Caelyx): in addition to being used in therapy for breast and ovarian cancer, the drug is also prescribed to treat multiple myeloma. Take 30 mg / m2 of body surface area on day 4 of each 3-week cycle, with the drug bortezomib. Continue with this therapeutic scheme until symptoms improve, without too many side effects.

Thalidomide (eg. Thalidomide Celgene, Thalidomide CEG): available in 50 mg tablets, the drug is widely used in therapy for the treatment of multiple myeloma, often associated with prednisone and melphalan. Take 4 tablets of active ingredient a day, before bed, on a full stomach or on an empty stomach. Each treatment cycle lasts 6 weeks: do not exceed 12 cycles. Do not use in children and young people under the age of 18. Do not take during pregnancy: the drug is a teratogenic substance.

Lenalidomide (eg Revlimid): take the anticancer drug orally, in the form of tablets (5-25 mg): it is prescribed to patients with multiple myeloma who have previously undergone specific treatment, which has not brought benefits. Take the active ingredient once a day for 21 days; continue with a week off. Repeat this treatment schedule as prescribed by your doctor. As for the association with Dexamethasone (eg Decadron, Soldesam), the recommended dosage is 40 mg once a day in the first 4 days of treatment with the anticancer agent; repeat the administration on the days between the 9th and 12th days, and between the 17th and 20th days. Maintain this schedule for the first 4 months of therapy. For any further months of treatment, Dexamethasone should only be taken in the first 4 days of each month. Consult your doctor.

Plerixafor (eg MOZOBIL): useful first stem cell transplantation for lymphoma and multiple myeloma patients. The drug is also taken after the administration of particular hormones (granulocyte colony stimulating factor) and is used to help harvest stem cells for transplantation. The posology must be carefully perfected by the doctor. However, the drug is taken by subcutaneous injection 6-11 hours before stem cell extraction.

Interferon Alfa-2b (eg. Introna): this drug, obtained exclusively upon medical prescription, belongs to the pharmaceutical class of interferons and is therapeutic indication both for the treatment of some forms of hepatitis, and for the treatment of multiple myeloma, chronic myeloid leukemia and hairy cell leukemia. The dose, always indicative and variable from patient to patient, is as follows: 2-20 million IU / m2 of body surface area, three times a week, alternating one day of treatment with one of rest. Treatment is generally continued for 6 months, or until symptoms are resolved without signs of severe toxicity.

The bisphosphonate drugs are instead used to reduce hypercalcemia and joint pain, and for the prophylaxis of bone remodeling caused by multiple myeloma.