treatment of the underlying disease
Younger fitter patients will receive combination
chemotherapy with the aim of eliminating all detectable
signs of the disease both clinically and by laboratory
tests. This is called a complete response.
This may be followed by a stem cell transplant carried
out using the patient’s own stem cells known as an
More elderly patients may be treated with more gentle
chemotherapy regimes aimed at achieving a stable response
without any attempt to eradicate the disease.
Thalidomide was used briefly in the 1950s for prevention of
morning sickness during pregnancy. It was withdrawn from the
market because it was found to cause severe congenital limb
Under stringent control it was re-introduced for the
treatment of multiple myeloma as it is effective in
preventing new blood vessel formation and also modifies the
behaviour of the immune system.
The MRC UK Myeloma IX study showed the combination of
cyclophosphamide, thalidomide and dexamethasone to be most
effective in the first line treatment of patients with