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Elotuzumab (trade name: Empliciti) has been approved in Germany since May 2016 for the treatment of multiple myeloma. The drug is an option for adult patients who have already had treatment at least once. It is combined with the drugs lenalidomide and dexamethasone.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: September 21, 2016

Multiple myeloma (MM) is cancer of the bone marrow. It causes bone destruction that leads to pain, spinal cord compression and fractures.In early stages, most people do not show any symptoms of MM. It is not clear whether it is better to start treatment with cancer drugs straight after diagnosis, or to wait until symptoms of the disease appear. The review of trials found that early treatment slows the progression of the disease. However, there is not enough evidence, due to too few studies conducted in patients with early stage myeloma to show that early treatment improves the survival of people with MM.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Multiple myeloma is a cancer of antibody‐producing cells in the bone marrow. It causes bone destruction and patients are usually at a higher risk for infections and renal damage. Autologous stem cell transplantation has been established as standard initial treatment for fit patients with symptomatic multiple myeloma. During autologous stem cell transplantation, blood‐forming stem cells are removed from the patient prior to intense chemotherapy and later given back to the same patient. The chemotherapy is aimed at killing tumour cells (the higher the dose the more tumour cells are killed) but also affects normal blood‐forming cells that are needed to fight infections, transport oxygen and control bleeding. By giving the patient back his or her own blood‐forming cells, the recovery from the chemotherapy is notably faster and better. Since it is unclear whether autologous stem cell transplantation as initial treatment of multiple myeloma should be performed once or twice, we systematically searched for publications addressing the question whether the acute toxicity of autologous stem cell transplantation is counterbalanced by a long‐term benefit for the patient. Several studies in which patients undergoing one treatment with autologous stem cell transplantation were compared to patients undergoing autologous stem cell transplantation twice were identified. Only five of 14 studies identified could be analysed in the present systematic review. We were interested in long‐term benefit for patients with respect to overall survival or so called event‐free survival, that is survival without disease progression. Quality of life and treatment‐related mortality should also be analysed in clinical studies.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Multiple myeloma (also known as myeloma or plasma cell myeloma) is a B‐cell malignancy or, more precisely, plasma cell neoplasm. This cancer grows inside or outside of bones. The bone damage, or osteolytic lesions, may lead to fractures of the long bones or compression fractures in the spine. The mechanism of bone destruction appears to be related to increased bone resorption by cells called osteoclasts. Bisphosphonates are drugs that can inhibit bone resorption by reducing the number and activity of osteoclasts. This updated review of 20 trials enrolling 6692 patients shows that adding bisphosphonates to myeloma treatment reduces fractures of the vertebra and bone pain. Zoledronate is better than etidronate and placebo alone, but not superior to pamidronate or clodronate for improving overall survival and any other outcomes such as vertebral and nonvertebral fractures.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Multiple myeloma is a type of blood cancer, affecting plasma cells inside the bone marrow. Bortezomib is a type of treatment for myeloma called a proteasome inhibitor. Proteasomes are enzymes found in all cells and play an important role in cell function and growth. Cancer cells are more sensitive to the effects of bortezomib, causing cancer cells to die or not grow any further.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Expert-reviewed information summary about the treatment of plasma cell neoplasms (including multiple myeloma).

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: September 8, 2017

We reviewed the existing literature regarding the efficacy and safety of additional plerixafor to granulocyte colony‐stimulating factors (G‐CSF) versus G‐CSF only for stem cell mobilisation in people with malignant lymphoma and multiple myeloma, cancers of the blood.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Viral infections cause significant disease and even death in patients with blood cancers. In the current systematic review of randomized controlled trials (RCTs) we aimed to evaluate the efficacy and safety of viral vaccines in these patients. The pre‐defined primary outcome was incidence of the infection concerned. Secondary outcomes were mortality due to the viral infection, all‐cause mortality, incidence of complications, incidence of severe viral infection, hospitalization rate, in vitro immune response and frequency of adverse effects. Eight RCTs were included. They evaluated heat‐inactivated varicella zoster virus (VZV) vaccine (two trials), influenza vaccines (five trials) and inactivated poliovirus vaccine (one trial). There were no RCTs on other viral vaccines (hepatitis A, hepatitis B, measles, mumps, rubella). Only the two trials on VZV vaccine reported our pre‐defined primary outcome. All trials reported some of the pre‐defined secondary outcomes. We found that inactivated VZV vaccine might reduce the severity of herpes zoster when given before and after stem cell transplant in adults with lymphoma or leukemia. Inactivated influenza vaccine might reduce upper and lower respiratory infections and hospitalization in adults with multiple myeloma who are undergoing chemotherapy, or children with leukemia or lymphoma within two years post‐chemotherapy. However, the quality of evidence is not high. Local adverse effects occur frequently with the vaccines, although serious adverse effects appear uncommon. Further high‐quality RCTs are needed to clarify the benefits and optimal regimens of viral vaccines for patients with blood cancers.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Patients with hematological malignancies are prone to infections due to defects in their immune system. One of the main defects is a reduction in the level of immunoglobulins. For many years, the notion was that administration of pooled immunoglobulins from healthy donors might reverse this defect. However, randomized controlled trials showed different results in terms of prolongation of survival, reduction of infections and side effects of treatments. We conducted a systematic review assessing the role of administration of immunoglobulins from healthy donors as prophylaxis in patients with hematological malignancies. Our review showed that in the context of bone marrow transplantation the administration of immunoglobulins did not have an effect on survival or other outcomes. On the other hand, in patients with lymphoproliferative disorders like chronic lymphocytic leukemia or multiple myeloma, it reduced substantially the rate of infections. Despite their high cost, prophylactic immunoglobulins might prove cost‐effective in this population.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Cancer patients are more likely than people without cancer to develop blood clots in their veins (known as venous thromboembolism). Chemotherapy further increases this risk. Yet a number of factors specific to the cancer, such as the bleeding tendency at the site of the cancer, or a relative decrease in the number of platelets in the blood (thrombocytopenia) caused by chemotherapy can increase the likelihood that cancer patients will have bleeding complications with medicines used to prevent and treat blood clots (anticoagulants). This systematic review looked at the effectiveness and safety of anticoagulants when used to prevent blood clots in cancer patients receiving chemotherapy.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

Prostate cancer is the most common cancer in men in many western countries and is characterized by its propensity to spread to bone which occurs in more than 80% of patients with advanced disease. Patients are at risk of complications including pain, hypercalcaemia, bone fracture and spinal cord compression. The role of bisphosphonates for the palliation of symptoms associated with advanced prostate cancer, was evaluated in this review. Pain relief was improved, and the incidence of skeletal events was reduced in patients receiving bisphosphonates compared to control patients. A significant increase in nausea was observed in patients who received bisphosphonates compared to placebo. Bisphosphonates do not appear to influence disease progression or patient survival, however, they should be considered as a palliative option in advanced prostate cancer.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

We reviewed the existing evidence regarding the effect of aerobic physical exercise plus standard care compared to standard care alone in adults with haematological malignancies. We found nine randomised controlled trials.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Since early 2011, the added benefit of most medications containing new active ingredients must be assessed as soon as they enter the market in Germany. The most important results of the IQWiG reviews are summarized here.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: August 24, 2017

Expert-reviewed information summary about the use of high-dose vitamin C as a treatment for people with cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: April 20, 2017

Expert-reviewed information summary about oral complications, such as mucositis and salivary gland dysfunction, that occur in cancer patients treated with chemotherapy or radiation therapy to the head and neck.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: December 16, 2016

Bisphosphonates give some relief from pain caused by cancer that has invaded bones. Patients with cancer that has spread to the bone frequently have pain. Pain control is an important part of cancer management. Bisphosphonates are medicines that affect the way bone develops, and are proving useful in treating patients with cancer that has invaded the bone (metastasis). This review looked at the effect of bisphosphonates on pain caused by bone metastases. Bisphosphonates do have some effect but are not as useful as either strong analgesics (such as morphine) or radiotherapy. However, where other methods of pain relief are inadequate, the addition of bisphosphonates can be beneficial. Bisphosphonates can cause nausea and vomiting.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

We evaluated the evidence about whether platelet transfusions given to prevent bleeding in people with lower platelet counts (for example 5 x 109/L or below) were as effective and safe as the current standard (10 x 109/L or below), or whether higher platelet count levels (20 x 109/L or below, 30 x 109/L or below, or 50 x 109/L or below) were safer than the current standard (10 x 109/L or below). Our target population was people with blood cancers (for example leukaemia, lymphoma, myeloma) who were receiving intensive (myelosuppressive) chemotherapy treatments or stem cell transplantation.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

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