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In two randomized phase III trials (MM-009 and MM-010), lenalidomide plus dexamethasone significantly prolonged time to progression and overall survival (OS) in patients with relapsed/refractory multiple myeloma compared with dexamethasone alone.
pDC levels are lower in multiple myeloma compared to control, the lowest levels being found in the clinically most advanced cases [ 47].
MDSCs containing the phenotype CD11b+CD14−HLA-DR−/lowCD33+CD15+ were found in the bone marrow and the peripheral blood of patients with active multiple myeloma compared with healthy donors [ 68].
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*Serum creatinine significantly higher in multiple myeloma patients compared with the dialysis population as a whole, P < 0.02.
IL-6 and TNF α were significantly increased in the bone marrow aspirate samples of patients with active multiple myeloma (MM) compared to those of normal controls.
Vacca et al (1999) were the first to demonstrate a significant increase in bone marrow angiogenesis (evaluated as microvessel area) in patients with active multiple myeloma (MM) compared with patients with nonactive MM and monoclonal gammopathy of undetermined significance (MGUS).
In two randomized phase 3 pivotal trials (MM-009 and MM-010), the oral IMiDs immunomodulatory drug lenalidomide was shown to improve outcomes when combined with dexamethasone in patients with relapsed/refractory multiple myeloma (RRMM), compared with dexamethasone alone.
There is currently a Phase III study in progress that focuses on patients with multiple myeloma and compares the effectiveness of denosumab to zoledronic acid in preventing skeletal-related events (NCT01345019).
Greater antiproliferative effects were seen across previously untreated multiple myeloma cell lines compared with bortezomib.
The findings corroborate evidence suggesting that suspecting the diagnosis of cancer is generally more challenging for cancers without specific symptoms (e.g., multiple myeloma, stomach cancer) compared with cancers with specific signs and symptoms (breast cancer, melanoma) (Rubin et al, 2011; Lyratzopoulos et al, 2012).
In this model, from the viewpoint of US healthcare payers, the total medical resource utilization costs (including therapy, disease management, and adverse events) for a bortezomib-treated patient with relapsed refractory multiple myeloma were $US65 222, compared with $US14 423 for a patient receiving BSC, based on median OS of 16 and 2.5 months, respectively (Mehta et al. 2004).
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