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Extended survival in advanced-stage multiple myeloma patients treated with gallium nitrate.

Abstract
Adjunctive anti-bone resorption therapy has become an important part of multiple myeloma (MM) treatment. Currently, no definite evidence exists that this therapy increases survival. We examined a cohort of 13 of 167 patients (8%) treated with the M-2 protocol who received adjuvant gallium nitrate (GN) treatment for osteolysis, and then compared the outcome of these patients to all individuals treated with the M-2 regimen. The stage at diagnosis was IA in two patients, IIIA in 10 patients and IIIB in one. Median age at diagnosis was 51 years (range 35-73). Median (range) of entry data were: paraprotein level: 6000mg/dl (3058-8675); beta2M: 2.7mg/l, (1.2-9.6); LDH: 166U/l (142-237); hemoglobin: 10.2 g/dl (8.3-12.6); albumin: 3.7 g/dl (2.5-5.0); calcium: 10.0 mg/dl (8.3-14.5); creatinine: 1.2 mg/dl (0.7-2.7). Median survival in these patients was 87+ months from time of diagnosis compared with 48 months for all other patients treated on the M-2 protocol. We identified a subgroup of patients with remarkably prolonged survival who had received M-2 chemotherapy and GN. Survival in this group markedly exceeds expectations for patients with advanced stage disease and poor prognostic features. The administration of GN may have a positive impact on survival either by decreasing skeletal complications or through a direct action of GN on the complex cytokine network involved in the proliferation of the malignant myeloma cell.
AuthorsRuben Niesvizkya, C Galen Choy, David Siegel, Larry Lyons, Joseph Michaeli
JournalLeukemia & lymphoma (Leuk Lymphoma) Vol. 43 Issue 3 Pg. 603-5 (Mar 2002) ISSN: 1042-8194 [Print] United States
PMID12002765 (Publication Type: Journal Article)
Chemical References
  • Antineoplastic Agents
  • Gallium
  • gallium nitrate
Topics
  • Adult
  • Aged
  • Antineoplastic Agents (administration & dosage)
  • Antineoplastic Combined Chemotherapy Protocols (administration & dosage)
  • Bone Resorption (drug therapy, etiology, mortality)
  • Cohort Studies
  • Drug Evaluation
  • Female
  • Gallium (administration & dosage)
  • Humans
  • Male
  • Middle Aged
  • Multiple Myeloma (complications, drug therapy, mortality)
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome

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