0
No votes yet

The Changing Treatment Paradigm in Patients With Newly Diagnosed Multiple Myeloma: Implications for Nursing

Joseph D. Tariman
Stella Marie Estrella
ONF 2005, 32(6), E127-E138 DOI: 10.1188/05.ONF.E127-E138

Purpose/Objectives: To review the changing treatment paradigm for newly diagnosed multiple myeloma and its implications for nursing.

References 

Adams, J. (2003a). Potential for proteasome inhibition in the treatment of cancer. <i>Drug Discovery Today, 8</i>, 307-315.

Adams, J. (2003b). The proteasome: Structure, function, and role in the cell. <i>Cancer Treatment Reviews, 29</i>(Suppl. 1), 3-9.

Alberts, D.S., Chang, S.Y., Chen, H.S., Evans, T.L., & Moon, T.E. (1979). Oral melphalan kinetics. <i>Clinical Pharmacology and Therapeutics, 26</i>, 737-745.

Alexanian, R., Barlogie, B., & Tucker, S. (1990). VAD-based regimens as primary treatment for multiple myeloma. <i>American Journal of Hematology, 33</i>(2), 86-89.

Alexanian, R., Dimopoulos, M.A., Delasalle, K., & Barlogie, B. (1992). Primary dexamethasone treatment of multiple myeloma. <i>Blood, 80</i>, 887-890.

Ali, S.M., Esteva, F.J., Hortobagyi, G., Harvey, H., Seaman, J., Knight, R., et al. (2001). Safety and efficacy of bisphosphonates beyond 24 months in cancer patients. <i>Journal of Clinical Oncology, 19</i>, 3434-3437.

Alsina, M., Fonseca, R., Wilson, E.F., Belle, A.N., Gerbino, E., Price-Toska, T., et al. (2004). Farnesyltransferase inhibitor tipifarnib is well tolerated, induces stabilization of disease and inhibits farnesylation and oncogenic/tumor survival pathways in patients with advanced multiple myeloma. <i>Blood, 103</i>, 3271-3277.

Anagnostopoulos, A., Aleman, A., Ayers, G., Donato, M., Champlin, R., Weber, D., et al. (2004). Comparison of high-dose melphalan with a more intensive regimen of thiotepa, busulfan, and cyclophosphamide for patients with multiple myeloma. <i>Cancer, 100</i>, 2607-2612.

Anderson, K.C. (2003). Moving disease biology from lab to the clinic. <i>Cancer, 97</i>(3, Suppl.), 796-801.

Anderson, K.C., Hamblin, T.J., & Traynor, A. (1999). Management of multiple myeloma today. <i>Seminars in Hematology, 36</i>(1, Suppl. 3), 3-8.

Attal, M., Harousseau, J.L., Facon, T., Guilhot, F., Doyen, C., Fuzibet, J.G., et al. (2003). Single versus double autologous stem-cell transplantation for multiple myeloma. <i>New England Journal of Medicine, 349</i>, 2495-2502.

Badros, A., Barlogie, B., Siegel, E., Morris, C., Desikan, R., Zangari, M., et al. (2001). Autologous stem cell transplantation in elderly multiple myeloma patients over the age of 70 years. <i>British Journal of Haematology, 114</i>, 600-607.

Badros, A., Barlogie, B., Siegel, E., Roberts, J., Langmaid, C., Zangari, M., et al. (2001). Results of autologous stem cell transplant in multiple myeloma patients with renal failure. <i>British Journal of Haematology, 114</i>, 822-829.

Barlogie, B., Desikan, R., Eddlemon, P., Spencer, T., Zeldis, J., Munshi, N., et al. (2001). Extended survival in advanced and refractory multiple myeloma after single-agent thalidomide: Identification of prognostic factors in a phase 2 study of 169 patients. <i>Blood, 98</i>, 492-494.

Barlogie, B., Jagannath, S., Vesole, D.H., Naucke, S., Cheson, B., Mattox, S., et al. (1997). Superiority of tandem transplantation over standard therapy for previously untreated multiple myeloma. <i>Blood, 89</i>, 789-793.

Barlogie, B., Shaughnessy, J., Tricot, G., Jacobson, J., Zangari, M., Anaissie, E., et al. (2004). Treatment of multiple myeloma. <i>Blood, 103</i>, 20-32.

Barlogie, B., Tricot, G., & Anaissie, E. (2001). Thalidomide in the management of multiple myeloma. <i>Seminars in Oncology, 28</i>, 577-582.

Barosi, G., Boccadoro, M., Cavo, M., Corradini, P., Marchetti, M., Massaia, M., et al. (2004). Management of multiple myeloma and related-disorders: Guidelines from the Italian Society of Hematology (SIE), Italian Society of Experimental Hematology (SIES) and Italian Group for Bone Marrow Transplantation (GITMO). <i>Haematologica, 89</i>, 717-741.

Bataille, R., & Harousseau, J.L. (1997). Multiple myeloma. <i>New England Journal of Medicine, 336</i>, 1657-1664.

Berenson, J.B., Lichtenstein, A., Porter, L., Dimopoulos, M.A., Bordoni, R., George, S., et al. (1996). Efficacy of pamidronate in reducing skeletal events in patients with advanced multiple myeloma. <i>New England Journal of Medicine, 334</i>, 488-493.

Berenson, J.R., Hillner, B.E., Kyle, R.A., Anderson, K., Lipton, A., Yee, G.C., et al. (2002). American Society of Clinical Oncology clinical practice guidelines: The role of bisphosphonates in multiple myeloma. <i>Journal of Clinical Oncology, 20</i>, 3719-3736.

Blade, J., Sampson, D., Reece, D., Apperley, J., Bjorkstrand, B., Gahrton, G., et al. (1998). Criteria for evaluating disease response and progression in patients with multiple myeloma treated by high-dose therapy and haemopoietic stem cell transplant. <i>British Journal of Haematology, 102</i>, 1115-1123.

Body, J.J. (2003). Zoledronic acid: An advance in tumour bone disease therapy and a new hope for osteoporosis. <i>Expert Opinion on Pharmaco-therapy, 4</i>, 567-580.

Bumm, K., Zheng, M., Bailey, C., Zhan, F., Chiriva-Internati, M., Eddlemon, P., et al. (2002). CGO: Utilizing and integrating gene expression microarray data in clinical research and data management. <i>Bioinformatics, 18</i>, 327-328.

Cancer pain relief and palliative care: Report of a WHO expert committee. (1990). <i>World Health Organization Technical Reports and Service, 804</i>, 1-75.

Catley, L., Weisberg, E., Tai, Y.T., Atadja, P., Remiszewski, S., Hideshima, T., et al. (2003). NVP-LAQ824 is a potent novel histone deacetylase inhibitor with significant activity against multiple myeloma. <i>Blood, 102</i>, 2615-2622.

Cavenagh, J.D., Curry, N., Stec, J., Drake, M., Morris, T.C.M., Agrawal, S., et al. (2004). PAD therapy (bortezomib, doxorubicin and dexamethasone) for untreated multiple myeloma (multiple myeloma) [Abstract 6550]. <i>Proceedings of the American Society of Clinical Oncology, 22</i>, 570s.

Chauhan, D., Catley, L., Hideshima, T., Li, G., Leblanc, R., Gupta, D., et al. (2002). 2-Methoxyestradiol overcomes drug resistance in multiple myeloma cells. <i>Blood, 100</i>, 2187-2194.

Chauhan, D., Uchiyama, H., Akbarali, Y., Urashima, M., Yamamoto, K., Libermann, T.A., et al. (1996). Multiple myeloma cell adhesion-induced interleukin-6 expression in bone marrow stromal cells involves activation of NF-kappa B. <i>Blood, 87</i>, 1104-1112.

Claudio, J.O., Masih-Khan, E., & Stewart, A.K. (2004). Insights from the gene expression profiling of multiple myeloma. <i>Current Hematology Reports, 3</i>, 67-73.

Colson, K., Doss, D.S., Swift, R., Tariman, J., & Thomas, T.E. (2004). Bortezomib, a newly approved proteasome inhibitor for the treatment of multiple myeloma: Nursing implications. <i>Clinical Journal of Oncology Nursing, 8</i>, 473-480.

Corral, L.G., Haslett, P.A., Muller, G.W., Chen, R., Wong, L.M., Ocampo, C.J., et al. (1999). Differential cytokine modulation and T cell activation by two distinct classes of thalidomide analogues that are potent inhibitors of TNF-alpha. <i>Journal of Immunology, 163</i>, 380-386.

Davies, F.E., Raje, N., Hideshima, T., Lentzsch, S., Young, G., Tai, Y.T., et al. (2001). Thalidomide and immunomodulatory derivatives augment natural killer cell cytotoxicity in multiple myeloma. <i>Blood, 98</i>, 210-216.

Dimopoulos, M.A., Palumbo, A., Delasalle, K.B., & Alexanian, R. (1994). Primary plasma cell leukemia. <i>British Journal of Haematology, 88</i>, 754-759.

Dredge, K., Marriott, J.B., Macdonald, C.D., Man, H.W., Chen, R., Muller, G., et al. (2002). Novel thalidomide analogues display anti-angiogenic activity independently of immunomodulatory effects. <i>British Journal of Cancer, 87</i>, 1166-1172.

Durie, B., & Stepan, D. (2001). Low dose thalidomide alone and in combination: Long term follow-up [Abstract 688]. <i>Blood, 98</i>, 163a.

Durie, B.G., & Salmon, S.E. (1975). A clinical staging system for multiple myeloma: Correlation of measured myeloma cell mass with presenting clinical features, response to treatment and survival. <i>Cancer, 36</i>, 842-854.

Durie, B.G., Salmon, S.E., & Moon, T.E. (1980). Pretreatment tumor mass cell kinetics and prognosis in multiple myeloma. <i>Blood, 55</i>, 364-372.

Fellowes, D., Barnes, K., & Wilkinson, S. (2004). Aromatherapy and massage for symptom relief in patients with cancer. <i>Cochrane Database of Systematic Reviews, 2</i>, CD002287.

Gautier, M., & Cohen, H.J. (1994). Multiple myeloma in the elderly. <i>Journal of American Geriatrics Society, 42</i>, 653-664.

Gupta, D., Treon, S.P., Shima, Y., Hideshima, T., Podar, K., Tai, Y.T., et al. (2001). Adherence of multiple myeloma cells to bone marrow stromal cells upregulates vascular endothelial growth factor secretion: Therapeutic applications. <i>Leukemia, 15</i>, 1950-1961.

Harousseau, J.L., & Moreau, P. (2002). Prognostic factors in myeloma. In J. Mehta & S. Singhal (Eds.), <i>Myeloma</i> (pp. 169-183). London: Martin Dunitz.

Hayashi, T., Hideshima, T., & Anderson, K.C. (2003). Novel therapies for multiple myeloma. <i>British Journal of Haematology, 120</i>, 10-17.

He, Y., Wheatley, K., Clark, O., Glasmacher, A., Ross, H., & Djulbegovic, B. (2003). Early versus deferred treatment for early stage multiple myeloma. <i>Cochrane Database of Systematic Reviews, 1</i>, CD004023.

Hideshima, T., Chauhan, D., Shima, Y., Raje, N., Davies, F.E., Tai, Y.T., et al. (2000). Thalidomide and its analogs overcome drug resistance of human multiple myeloma cells to conventional therapy. <i>Blood, 96</i>, 2943-2950.

Hussein, M. (2003). Pegylated liposomal doxorubicin, vincristine, and reduced-dose dexamethasone as first-line therapy for multiple myeloma. <i>Clinical Lymphoma, 4</i>(Suppl. 1), S18-S22.

Jagannath, S., Durie, B., Wolf, J., Camacho, E., Irwin, D., Lutzky, J., et al. (2004). First-line therapy with bortezomib (formerly PS-341) in patients with multiple myeloma (multiple myeloma) [Abstract 6551]. <i>Proceedings of the American Society of Clinical Oncology, 22</i>, 570s.

Kumar, S., Lacy, M.Q., Dispenzieri, A., Rajkumar, S.V., Fonseca, R., Geyer, S., et al. (2004). Single agent dexamethasone for pre-stem cell transplant induction therapy for multiple myeloma. <i>Bone Marrow Transplantation, 34</i>, 485-490.

Kyle, R.A. (2002). Diagnosis and treatment of multiple myeloma in the elderly. <i>Clinical Geriatrics, 10</i>(11), 47-56.

Kyle, R.A., Gertz, M.A., Witzig, T.E., Lust, J.A., Lacy, M.Q., Dispenzieri, A., et al. (2003). Review of 1027 patients with newly diagnosed multiple myeloma. <i>Mayo Clinic Proceedings, 78</i>, 21-33.

Kyle, R.A., & Greipp, P.R. (1980). Smoldering multiple myeloma. <i>New England Journal of Medicine, 302</i>, 1347-1349.

Kyle, R.A., & Lust, J.A. (1996). Immunoglobulins and laboratory recognition of monoclonal proteins. In R.A. Kyle (Ed.)<i>Neoplastic diseases of the blood</i> (pp. 453-475). New York: Churchill Livingstone.

Kyle, R.A., & Rajkumar, S.V. (2001). Therapeutic application of thalidomide in multiple myeloma. <i>Seminars in Oncology, 28</i>, 583-587.

Lin, B., Podar, K., Gupta, D., Tai, Y.T., Li, S., Weller, E., et al. (2002). The vascular endothelial growth factor receptor tyrosine kinase inhibitor PTK787/ZK222584 inhibits growth and migration of multiple myeloma cells in the bone marrow microenvironment. <i>Cancer Research, 62</i>, 5019-5026.

Lokhorst, H. (2002). Clinical features and diagnostic criteria. In J. Mehta & S. Singhal (Eds.), <i>Myeloma</i> (pp. 151-168). London: Martin Dunitz.

Magagnoli, M., Castagna, L., Balzarotti, M., Sarina, B., Timofeeva, I., Bertuzzi, A., et al. (2003). Feasibility and toxicity of high-dose therapy (HDT) supported by peripheral blood stem cells in elderly patients with multiple myeloma and non-Hodgkin's lymphoma: Survey from a single institution. <i>American Journal of Hematology, 73</i>, 267-272.

Major, P., Lortholary, A., Hon, J., Abdi, E., Mills, G., Menssen, H.D., et al. (2001). Zoledronic acid is superior to pamidronate in the treatment of hypercalcemia of malignancy: A pooled analysis of two randomized, controlled clinical trials. <i>Journal of Clinical Oncology, 19</i>, 558-567.

Maxwell, C., Swift, R., Goode, M., Doane, L., & Rogers, M. (2003). Advances in supportive care of patients with cancer and bone metastasis: Nursing implications of zoledronic acid. <i>Clinical Journal of Oncology Nursing, 7</i>, 403-408.

Mehta, J. (2002). Allogeneic hematopoietic stem cell transplantation in myeloma. In J. Mehta & S. Singhal (Eds.), <i>Myeloma</i> (pp. 349-365). London: Martin Dunitz.

Mitsiades, C.S., Mitsiades, N.S., McMullan, C.J., Poulaki, V., Shringarpure, R., Hideshima, T., et al. (2004). Transcriptional signature of histone deacetylase inhibition in multiple myeloma: Biological and clinical applications. <i>Proceedings of National Academy of Sciences of the United States of America, 101</i>, 540-545.

Mitsiades, N., Mitsiades, C.S., Poulaki, V., Chauhan, D., Fanourakis, G., Gu, X., et al. (2002). Molecular sequelae of proteasome inhibition in human multiple myeloma cells. <i>Proceedings of National Academy of Sciences of the United States of America, 99</i>, 14374-14379.

Mooberry, S.L. (2003). New insights into 2-methoxyestradiol, a promising antiangiogenic and antitumor agent. <i>Current Opinion in Oncology, 15</i>, 425-430.

Munshi, N., Desikan, K., & Barlogie, B. (2000). Clinical experience with thalidomide in multiple myeloma: Phase II trials in refractory disease and ongoing studies. <i>Seminars in Hematology, 37</i>(Suppl. 3), 15-21.

National Comprehensive Cancer Network. (2004). <i>NCCN 2004 clinical practice guidelines in oncology: Multiple myeloma</i> [CD-ROM]. Jenkin-town, PA: Author.

Ochiai, N., Uchida, R., Fuchida, S., Okano, A., Okamoto, M., Ashihara, E., et al. (2003). Effect of farnesyl transferase inhibitor R115777 on the growth of fresh and cloned myeloma cells in vitro. <i>Blood, 102</i>, 3349-3353.

Palmer, M., Belch, A., Hanson, J., & Brox, L. (1988). Dose intensity analysis of melphalan and prednisone in multiple myeloma. <i>Journal of the National Cancer Institute, 80</i>, 414-418.

Prevention of Pneumococcal disease: Recommendations of the advisory committee immunization practices (ACIP). (1997). <i>Morbidity and Mortality Weekly Report, 4</i>(46), 1-24.

Raje, N., & Anderson, K.C. (2002). Thalidomide and immunomodulatory drugs as cancer therapy. <i>Current Opinion in Oncology, 14</i>, 635-640.

Rajkumar, S.V., Blood, E., Vesole, D.H., Shepard, R., & Greipp, P.R. (2004). A randomized phase II trial of thalidomide plus dexamethasone versus dexamethasone in newly diagnosed multiple myeloma (E1A00): A trial coordinated by the Eastern Cooperative Group [Abstract 6508]. <i>Proceedings of the American Society of Clinical Oncology, 22</i>, 560s.

Rajkumar, S.V., Gertz, M.A., Kyle, R.A., & Greipp, P.R. (2002). Current therapy for multiple myeloma. <i>Mayo Clinic Proceedings, 77</i>, 813-822.

Rajkumar, S.V., & Greipp, P.R. (2002). Plasma cells and immunoglobulins. In J. Mehta & S. Singhal (Eds.), <i>Myeloma</i> (pp. 3-23). London: Martin Dunitz.

Rajkumar, S.V., Hayman, S., Gertz, M.A., Dispenzieri, A., Lacy, M.Q., Greipp, P.R., et al. (2002). Combination therapy with thalidomide plus dexamethasone for newly diagnosed myeloma. <i>Journal of Clinical Oncology, 20</i>, 4319-4323.

Richardson, P., Jagannath, S., Schlossman, R.L., Weller, E., Zeldenrust, S., Rajkumar, V., et al. (2002). A multi-center, randomized, phase II study to evaluate the efficacy and safety of two CDC-5013 dose regimens when used alone or in combination with dexamethasone for the treatment of relapsed or refractory multiple myeloma [Abstract 386]. <i>Blood, 100</i>, 104a.

Richardson, P., Schlossman, R.L., Hideshima, T., Davies, F.E., Leblanc, R., Catley, L., et al. (2001). A phase 1 study of oral CC5013, an immunomodulatory thalidomide (thal) derivative, in patients with relapsed and refractory multiple myeloma [Abstract 3225]. <i>Blood, 98</i>, 775a.

Richardson, P.G., Barlogie, B., Berenson, J., Singhal, S., Jagannath, S., Irwin, D., et al. (2003). A phase 2 study of bortezomib in relapsed, refractory myeloma. <i>New England Journal of Medicine, 348</i>, 2609-2617.

Richardson, P.G., Schlossman, R.L., Weller, E., Hideshima, T., Mitsiades, C., Davies, F., et al. (2002). Immunomodulatory drug CC5013 overcomes drug resistance and is well tolerated in patients with relapsed multiple myeloma. <i>Blood, 100</i>, 3063-3067.

Rosen, L., Harland, S.J., & Oosterlinck, W. (2002). Broad clinical activity of zoledronic acid in osteolytic to osteoblastic bone lesions in patients with a broad range of solid tumors. <i>American Journal of Clinical Oncology, 25</i>(6, Suppl. 1), S19-S24.

Rosen, L.S., Gordon, D., Kaminsky, M., Howell, A., Belch, A., Mackey, J., et al. (2003). Long-term efficacy and safety of zoledronic acid compared with pamidronate disodium in the treatment of skeletal complications in patients with advanced multiple myeloma or breast carcinoma: A randomized, double blind, multicenter, comparative trial. <i>Cancer, 98</i>, 1735-1744.

Samson, D., Gaminara, E., Newland, A., Van de Pette, J., Kearney, J., McCarthy, D., et al. (1989). Infusion of vincristine and doxorubicin with oral dexamethasone as first-line therapy for multiple myeloma. <i>Lancet, 2</i>, 882-885.

Santucci, R., Mackley, P.A., Sebti, S., & Alsina, M. (2003). Farnesyltransferase inhibitors and their role in the treatment of multiple myeloma. <i>Cancer Control, 10</i>, 384-387.

Schey, S.A., Fields, P., Bartlett, J.B., Clark, I.A., Ashan, G., Knight, R.D., et al. (2004). Phase I study of an immunomodulatory thalidomide analogue, CC-4047, in relapsed or refractory multiple myeloma. <i>Journal of Clinical Oncology, 22</i>, 3269-3276.

Siegel, D.S., Desikan, K.R., Mehta, J., Singhal, S., Fassas, A., Munshi, N., et al. (1999). Age is not a prognostic variable with autotransplants for multiple myeloma. <i>Blood, 93</i>, 51-54.

Singhal, S. (2002). High-dose therapy and autologous transplantation. In J. Mehta & S. Singhal (Eds.), <i>Myeloma</i> (pp. 327-347). London: Martin Dunitz.

Singhal, S., Mehta, J., Desikan, R., Ayers, D., Roberson, P., Eddlemon, P., et al. (1999). Antitumor activity of thalidomide in refractory multiple myeloma. <i>New England Journal of Medicine, 341</i>, 1565-1571.

Sirohi, B., Powles, R., Mehta, J., Treleaven, J., Raje, N., Kulkarni, S., et al. (2001). The implication of compromised renal function at presentation in myeloma: Similar outcome in patients who receive high-dose therapy: A single-center study of 251 previously untreated patients. <i>Medical Oncology, 18</i>, 39-50.

Skerjanec, A., Berenson, J., Hsu, C., Major, P., Miller, W.H., Jr., Ravera, C., et al. (2003). The pharmacokinetics and pharmacodynamics of zoledronic acid in cancer patients with varying degree of renal function. <i>Journal of Clinical Pharmacology, 43</i>, 154-162.

Sonneveld, P., & Segeren, C.M. (2003). Changing concepts in multiple myeloma: From conventional chemotherapy to high-dose treatment. <i>European Journal of Cancer, 39</i>, 9-18.

Tariman, J.D. (2003a). Thalidomide: Current therapeutic uses and management of its toxicities. <i>Clinical Journal of Oncology Nursing, 7</i>, 143-147.

Tariman, J.D. (2003b). Understanding novel therapeutic agents for multiple myeloma. <i>Clinical Journal of Oncology Nursing, 7</i>, 521-528.

Tariman, J.D. (2005). Multiple myeloma. In C.H. Yarbro, M.H. Frogge, & M. Goodman (Eds.), <i>Cancer nursing principles and practice</i> (6th ed., pp. 1460-1489). Sudbury, MA: Jones and Bartlett

Tariman, J.D., & Lemoine, C. (2003). Bortezomib. <i>Clinical Journal of Oncology Nursing, 7</i>, 687-689.

Terpos, E., Apperley, J.F., Samson, D., Giles, C., Crawley, C., Kanfer, E., et al. (2003). Autologous stem cell transplantation in multiple myeloma: Improved survival in nonsecretory multiple myeloma but lack of influence of age, status at transplant, previous treatment and conditioning regimen. A single-centre experience in 127 patients. <i>Bone Marrow Transplantation, 31</i>, 163-170.

Terpos, E., Viniou, N., de la Fuente, J., Meletis, J., Voskaridou, E., Karkantaris, C., et al. (2003). Pamidronate is superior to ibandronate in decreasing bone resorption, interleukin-6 and beta 2-microglobulin in multiple myeloma. <i>European Journal of Haematology, 70</i>, 34-42.

Thompson, J.L., & Hansen, L.A. (2003). Thalidomide dosing in patients with relapsed or refractory multiple myeloma. <i>Annals of Pharmacotherapy, 37</i>, 571-576.

Vanderkerken, K., De Leenheer, E., Shipman, C., Asosingh, K., Willems, A., Van Camp, B., et al. (2003). Recombinant osteoprotegerin decreases tumor burden and increases survival in a murine model of multiple myeloma. <i>Cancer Research, 63</i>, 287-289.

Vescio, R., Schiller, G., Stewart, A.K., Ballester, O., Noga, S., Rugo, H., et al. (1999). Multicenter phase III trial to evaluate CD34(+) selected versus unselected autologous peripheral blood progenitor cell transplantation in multiple myeloma. <i>Blood, 93</i>, 1858-1868.

Weber, D., Rankin, K., Gavino, M., Delasalle, K., & Alexanian, R. (2003). Thalidomide alone or with dexamethasone for previously untreated multiple myeloma. <i>Journal of Clinical Oncology, 21</i>, 16-19.

Weber, D.M. (2003). A multicenter, randomized, parallel-group, double-blind, placebo-controlled study of CC-5013 plus dexamethasone versus dexamethasone alone in previously treated subjects with multiple myeloma: Protocol CC-5013-multiple myeloma-009. Retrieved December 20, 2004, from <a target="_blank" href='http://www.cro.lurie.northwestern.edu/Trials/MultipleMyeloma/MM_studies....

Wong, D.L. (1995). Health promotion of the infant and family. In D. Wilson (Ed.), <i>Nursing care of infants and children</i> (pp. 514-573). St. Louis, MO: Mosby.

Yakoub-Agha, I., Attal, M., Dumontet, C., Delannoy, V., Moreau, P., Berthou, C., et al. (2002). Thalidomide in patients with advanced multiple myeloma: A study of 83 patients—Report of the intergroupe francophone du myelome (IFM). <i>Hematology Journal, 3</i>, 185-192.

Zangari, M., Barlogie, B., Thertulien, R., Jacobson, J., Eddleman, P., Fink, L., et al. (2003). Thalidomide and deep vein thrombosis in multiple myeloma: Risk factors and effect on survival. <i>Clinical Lymphoma, 4</i>, 32-35.

Zeldis, J.B., Williams, B.A., Thomas, S.D., & Elsayed, M.E. (1999). S.T.E.P.S.: A comprehensive program for controlling and monitoring access to thalidomide. <i>Clinical Therapeutics, 21</i>, 319-330.

Zhan, F., Hardin, J., Kordsmeier, B., Bumm, K., Zheng, M., Tian, E., et al. (2002). Global gene expression profiling of multiple myeloma, monoclonal gammopathy of undetermined significance, and normal bone marrow plasma cells. <i>Blood, 99</i>, 1745-1757.

Zomas, A., & Dimopoulos, M.A. (2002). Conventional treatment of myeloma. In J. Mehta & S. Singhal (Eds.), <i>Myeloma</i> (pp. 313-326). London: Martin Dunitz.