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Itraconazole May Increase The Risk Of Early Peripheral Neuropathy In Myeloma Patients Receiving Velcade – Results of a recent Japanese study indicate that itraconazole (Sporanox), a medication used for the treatment of fungal infections, may increase a multiple myeloma patient’s risk of developing peripheral neuropathy during their first Velcade (bortezomib) treatment cycle. Peripheral neuropathy is a common side effect of Velcade that is characterized by pain and tingling in the extremities due to nerve damage. Based on their findings, the researchers recommend that the use of itraconazole should be avoided in patients receiving Velcade. For more information, please see the study in The International Journal of Hematology.

Myeloma Patients With Residual Disease After Initial Therapy May Require Additional Therapy Shortly After Transplant – French researchers recently evaluated the levels of myeloma cells and normal plasma cells seven days after stem cell transplantation for newly diagnosed multiple myeloma. Among patients who showed no residual myeloma cells after initial therapy, the researchers found that levels of myeloma cells remain undetectable seven days after stem cell transplantation. In addition, normal plasma cell levels increased threefold within seven days after stem cell transplantation in these patients. By comparison, among patients who showed residual myeloma cells after initial therapy, levels of myeloma cells were reduced but not eradicated seven days after stem cell transplantation. Normal plasma cell levels did not increase in these patients. Based on their findings, the researchers recommend that patients with residual disease receive additional therapy shortly after transplantation to kill off the remaining myeloma cells. For more information, please see the study in Oncotarget.

FLC Ratio May Be A Good Prognostic Marker For Progression From Smoldering To Active Myeloma – Researchers at the Mayo Clinic recently found that the free light chain (FLC) ratio may be a good prognostic marker for smoldering myeloma patients who are at high risk of progressing to active myeloma. The FLC assay is one of the standard blood tests used to diagnose multiple myeloma. Specifically, the researchers found that smoldering myeloma patients with a FLC ratio of 100 or higher progressed to active myeloma within a median of 15 months, compared to 55 months for smoldering myeloma patients with FLC ratio below 100. Based on their findings, the researchers recommend that smoldering myeloma patients with a FLC ratio of 100 or higher be treated early. For more information, please see the study in the journal Leukemia (abstract).

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A small study in Japan showed that relapsed multiple myeloma patients treated simultaneously with Velcade and itraconazole experienced greater Velcade-induced side effects, such as lower platelet levels and nerve damage to the extremities, than patients who did not receive itraconazole. 

The researchers recommended that multiple myeloma patients receiving both Velcade (bortezomib) and itraconazole (Sporanox) be closely monitored for Velcade-induced side effects throughout the duration of their treatment. 

However, according to Dr. Paul Richardson of the Dana-Farber Cancer Institute in Boston the results of the study should be interpreted cautiously. “Patients from …