Melphalan Causes Second Cancer in Multiple Myeloma, not Revlimid

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Second cancers, often the result of treatments received, are an especially big concern in the treatment of multiple myeloma.

Previous studies have linked various sources to an increased risk of second cancers in these patients, but a new study may give doctors and patients some ease when using one of the more novel agents to fight this disease.

Findings from this retrospective study may help ease concerns among multiple myeloma patients and their doctors about using Revlimid (lenalidomide) to treat their disease.

Researchers determined that patients given Revlimid in combination with low-dose oral melphalan (as opposed to high-dose melphalan, common in stem cell transplants) are five times as likely to develop a second blood cancer compared with those patients who receive melphalan alone.

Research team recommends certain course of drugs

This is in line with prior research done in the field that has shown an increased risk of second cancers with long-term melphalan exposure, as well as an increased risk of second cancers in newly diagnosed patients given Revlimid plus Melphalan, but not in those given Revlimid plus dexamethasone.

In order to avoid putting patients newly diagnosed with multiple myeloma at greater risk of developing second cancers, the research team, led by Antonio Palumbo, M.D., recommends using cyclophosphamide instead of melphalan or a drug similar to cyclophosphamide but not a drug that works in the manner that melphalan does in order to reduce the risk of second cancers in these patients.

Source: Lancet Oncology

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