Comprehensive reviews on the use of thalidomide have been published and include efficacy and safety in relapsed MM. The rationale for using thalidomide was based on its antiangiogenic properties because, in MM, increased microvessel density has been inversely correlated to survival. However, thalidomide has multiple modes of action, including immunomodulatory effects. This initial experience generated a great enthusiasm, and a large number

of phase II trials were rapidly conducted. A systematic review of such 42 trials on >1600 patients selleck inhibitor confirm that the response rate is 29 % with an estimated 1-year overall survival (OS) of 60 %. The well-known teratogenicity of thalidomide is not a major concern {Selleck Anti-infection Compound Library|Selleck Antiinfection Compound Library|Selleck Anti-infection Compound Library|Selleck Antiinfection Compound Library|Selleckchem Anti-infection Compound Library|Selleckchem Antiinfection Compound Library|Selleckchem Anti-infection Compound Library|Selleckchem Antiinfection Compound Library|Anti-infection Compound Library|Antiinfection Compound Library|Anti-infection Compound Library|Antiinfection Compound Library|Anti-infection Compound Library|Antiinfection Compound Library|Anti-infection Compound Library|Antiinfection Compound Library|Anti-infection Compound Library|Antiinfection Compound Library|Anti-infection Compound Library|Antiinfection Compound Library|Anti-infection Compound Library|Antiinfection Compound Library|Anti-infection Compound Library|Antiinfection Compound Library|Anti-infection Compound Library|Antiinfection Compound Library|buy Anti-infection Compound Library|Anti-infection Compound Library ic50|Anti-infection Compound Library price|Anti-infection Compound Library cost|Anti-infection Compound Library solubility dmso|Anti-infection Compound Library purchase|Anti-infection Compound Library manufacturer|Anti-infection Compound Library research buy|Anti-infection Compound Library order|Anti-infection Compound Library mouse|Anti-infection Compound Library chemical structure|Anti-infection Compound Library mw|Anti-infection Compound Library molecular weight|Anti-infection Compound Library datasheet|Anti-infection Compound Library supplier|Anti-infection Compound Library in vitro|Anti-infection Compound Library cell line|Anti-infection Compound Library concentration|Anti-infection Compound Library nmr|Anti-infection Compound Library in vivo|Anti-infection Compound Library clinical trial|Anti-infection Compound Library cell assay|Anti-infection Compound Library screening|Anti-infection Compound Library high throughput|buy Antiinfection Compound Library|Antiinfection Compound Library ic50|Antiinfection Compound Library price|Antiinfection Compound Library cost|Antiinfection Compound Library solubility dmso|Antiinfection Compound Library purchase|Antiinfection Compound Library manufacturer|Antiinfection Compound Library research buy|Antiinfection Compound Library order|Antiinfection Compound Library chemical structure|Antiinfection Compound Library datasheet|Antiinfection Compound Library supplier|Antiinfection Compound Library in vitro|Antiinfection Compound Library cell line|Antiinfection Compound Library concentration|Antiinfection Compound Library clinical trial|Antiinfection Compound Library cell assay|Antiinfection Compound Library screening|Antiinfection Compound Library high throughput|Anti-infection Compound high throughput screening| in patients with MM because of patients age, but justifies careful informing of patients and programs to avoid drug exposure in women with childbearing potential. The major toxicities of thalidomide are fatigue, somnolence, constipation, and mostly peripheral neuropathy, which are related to the daily dosage and to treatment duration. The overall incidence of peripheral neuropathy is 30 % but may be higher if treatment is prolonged for >1 year. Because this complication

LBH589 chemical structure may be disabling and sometimes irreversible, patients should decrease the dose or stop the treatment if significant numbness occurs. After induction treatment, two to four cycles of combination therapies is followed by the maintenance therapy, which is continuous therapy with a single agent, with reasonable balance between maximum benefits and minimum toxicities [24] until the time of disease progression. Maintenance therapy for multiple

myeloma I prefer disease control as a treatment goal, except in selected high-risk patients in whom an aggressive approach to achieving CR may be the only option to long-term survival (Fig. 5). The disease control approach involves targeting very good partial response Fossariinae (minimal residual disease) rather than CR as a goal by using limited, less intense therapy first and moving to more aggressive approaches as need arises (sequential approach): this allows patients to help determine the timing and number of transplants. Fig. 5 Strategy of myeloma treatment in our institute. We divided in four phases: initial therapy by two to four courses of BorDex/CyBorD/ or MPB >66 years old followed by PBSC-harvest. If the high risk patients, up-front PBSC-transplantation followed by Bor-maintenance. Otherwise, if the standard risks patients, maintenance-therapies may be the B-stages until progress disease. PD are defined as (1) above 10 % elevation of M-protein, (2) hypercalcemia, (3) anemia progress, (4) bone pain, (5) β2-MG elevation (6) additional chromosome ab. (7) BM myeloma cell elevation. After PD, problem-oriented PBSCT may be done with second maintenance with Lenalidomide Post-transplant consolidation/maintenance with novel agents can become an important step forward.