Myeloma

Biphosphonates for early myeloma – pro

There is increasing evidence that early treatment of smoldering myeloma with biphosphonates may e beneficial; however, the level of proof has nto yet reached the quality sufficient to change the guidelines or to modify existing coverage policies. The recently published American Society of Clinical Oncology clinical practice guidelines for the use of bisphosphonates (BPs) in multiple myeloma do not recommend use of these drugs in patients with monoclonal

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Sentinel lymph node biopsy: Melanoma – pro

Sentinel node sampling(SLND) is a technique most commonly used for staging breast cancer and melanoma. A dye, or more recently radionucleide is injectde into the tumor bed and is traced to the lymph node or nodes that predominantly drain that area. This node(s) is then sampled, avoiding extensive nodal dissection. Patients with melanomas less than or equal to 1.0 mm in thickness are at lower risk for nodal involvement (2-5%), and there is debate

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Velcade First Line in Multiple Myeloma – pro

There are relatively few effective treatment options for patients with multiple myeloma. Traditional treatment includes combination chemotherapy with melphalan/prednisone and vincristine/doxorubicin/dexamethasone. Myeloablation with high-dose chemotherapy and subsequent rescue with ASCT is a mainstay for patients fit enough to withstand the regimen, usually patients less than 65 years of age. The immunomodulators, thalidomide and lenalidomide, alone

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Super-BEAM for Myeloma – pro

BEAM Super is a 9 high dose chemo drugs over 5 days chemo regime. It is unique to the University of Arkansas Myeloma center. The regimen comprises BCNU at 300mg/m2 on day 1, etoposide 200mg/m2 on days 1-4; cytarabine 400mg/m2 on days 1-5; melphalan 140mg/m2 on day 5 plus: bortezomib 1.0-1.3mg/m2 on days 1+4, thalidomide 100-200mg on days 1-5, dexamethasone 20-40mg days 1-5, cisplatin 10-12.5mg/m2/d by continuous infusion on days 1-5, rapamycin 3mg

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Cytogenetics and flow for myeloma – pro

A recent workshop was conducted to agree on guidelines for use of FISH in myeloma. These recommendations arose from a workshop organized for the European Myeloma Network, held at the Royal Marsden Hospital, London on March 11th 2005. 31 European laboratories were represented at the meeting. These recommendations are intended to apply only to newly diagnosed cases of myeloma or frank relapse cases. The use of FISH to monitor response to high dose

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