Recent advances in multiple myeloma

Multiple myeloma is the second most common hematologic malignancy, with app roximately 15,000 new cases each year in the United States. Our understandi ng of the pathophysiology underlying myeloma continues to expand, but the c ause of this plasma cell dyscrasia remains unclear, Though controversy rema ins regarding a possible viral cause of myeloma, evidence suggesting a role for the human herpesvirus-8 is mounting, The roles of cytogenetic abnormal ities as well as aberrant angiogenesis and cytokine expression in the etiol ogy of myeloma continue to be explored and may lead to future therapeutic s trategies. Transplantation in myeloma is rarely curative but offers clinica l benefit not only for young but possibly for older myeloma patients as wel l. Newer bisphosphonates may offer greater ease of administration, improved efficacy, and possibly even enhanced antitumor effect. Finally, thalidomid e offers significant clinical benefit to patients with myeloma previously r efractory to multiple agents, and its role in early stages of the disease i s under investigation. (C) 2000 Lippincott Williams & Wilkins, Inc.