Progress of fixed-cycle therapy and continuous therapy in multiple myeloma / 白血病·淋巴瘤

Multiple myeloma (MM) accounts for 13％of hematological malignancies, which often happens in elderly patients. The introduction of new drugs and treatments has improved the patients'survival time significantly, but some patients may relapse at different stages of treatment. Some studies have demonstrated that lenalidomide, bortezomib or bortezomib combination regimen could improve progression-free survival (PFS) in the patients at standard risk or at high risk. In patients who are not suitable for transplantation, patients treated with lenalidomide plus dexamethasone regimen consistently have longer survival time than those treated with fixed-cycle melphalan plus prednisone, thalidomide regimen, so the optimal treatment is the appropriate choice. This article reviews the efficacy of fixed-cycle therapy and continuous therapy for post-transplant and non-transplant patients.

Consolidation, maintenance and continuous therapy for multiple myeloma in the era of novel agents / 肿瘤研究与临床

With the application of novel agents and high-dose chemotherapy with autologous stem cell transplantation(ASCT),the survival time of multiple myeloma(MM) has been significantly prolonged.However,due to the biological characteristics of myeloma and minimal residual disease after initial treatment,the disease courses of most MM patients show a series of remissions and relapses.Hence,it is necessary to apply consolidation and maintenance therapy after ASCT and continuous therapy for transplant-ineligible patients.This paper reviews the advances in consolidation,maintenance and continuous therapy for MM in the era of novel agents.

Use of cyclosporine in the treatment of psoriasis

Introduction The efficacy of cyclosporine in the treatment of psoriasis is well established. However widespread use of it has been limited by concerns over adverse effects such as hypertension, renal impairment and the potential risk of malignancy. The aim of this study is to determine the profile of our local psoriasis patients treated with cyclosporine, their response to treatment, their tolerability and the side-effects experienced. Materials and Methods This is a retrospective study of all psoriasis patients treated with cyclosporine for more than one month from January 1996 to June 2007 at the Department of Dermatology Ipoh Hospital. Results There were a total 21 patients, 8 males and 13 females. Their mean age was 40 years. There were 7 Malays, 10 Chinese and 4 Indians. Cyclosporine was given as the second or third line of treatment. The average starting dose was 2.76mg/kg and maximum dose was 3.89mg/kg. Best response was noted after 3 months of treatment. Thirteen (61.9%) patients had excellent response, 4(19%) had good response, 3 (14.3%) had moderate response and 1(4.8%) had poor response. Thirteen (61.9%) patients developed raised serum creatinine level exceeding 30% of the baseline while on treatment but all of them improved when the dosages of cyclosporine were reduced. None of them developed renal failure. There were 5 patients who had hypertension while on cyclosporine therapy, 2 of them required antihypertensive agents while for the remaining 3, blood pressure normalized after dosage reduction. Other side effects reported include gastrointestinal upset, gum hypertrophy and hypertrichosis. Conclusion Cyclosporine is effective in the treatment of psoriasis but close monitoring of serum creatinine and blood pressure is needed.