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

Joseph D. Tariman

Stella Marie Estrella

ONF 2006, 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.

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    References

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

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

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

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

    Alexanian, R., Dimopoulos, M.A., Delasalle, K., & Barlogie, B. (1992). Primary dexamethasone treatment of multiple myeloma. Blood, 80, 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. Journal of Clinical Oncology, 19, 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. Blood, 103, 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. Cancer, 100, 2607-2612.

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

    Anderson, K.C., Hamblin, T.J., & Traynor, A. (1999). Management of multiple myeloma today. Seminars in Hematology, 36(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. New England Journal of Medicine, 349, 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. British Journal of Haematology, 114, 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. British Journal of Haematology, 114, 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. Blood, 98, 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. Blood, 89, 789-793.

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

    Barlogie, B., Tricot, G., & Anaissie, E. (2001). Thalidomide in the management of multiple myeloma. Seminars in Oncology, 28, 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). Haematologica, 89, 717-741.

    Bataille, R., & Harousseau, J.L. (1997). Multiple myeloma. New England Journal of Medicine, 336, 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. New England Journal of Medicine, 334, 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. Journal of Clinical Oncology, 20, 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. British Journal of Haematology, 102, 1115-1123.

    Body, J.J. (2003). Zoledronic acid: An advance in tumour bone disease therapy and a new hope for osteoporosis. Expert Opinion on Pharmaco-therapy, 4, 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. Bioinformatics, 18, 327-328.

    Cancer pain relief and palliative care: Report of a WHO expert committee. (1990). World Health Organization Technical Reports and Service, 804, 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. Blood, 102, 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]. Proceedings of the American Society of Clinical Oncology, 22, 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. Blood, 100, 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. Blood, 87, 1104-1112.

    Claudio, J.O., Masih-Khan, E., & Stewart, A.K. (2004). Insights from the gene expression profiling of multiple myeloma. Current Hematology Reports, 3, 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. Clinical Journal of Oncology Nursing, 8, 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. Journal of Immunology, 163, 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. Blood, 98, 210-216.

    Dimopoulos, M.A., Palumbo, A., Delasalle, K.B., & Alexanian, R. (1994). Primary plasma cell leukemia. British Journal of Haematology, 88, 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. British Journal of Cancer, 87, 1166-1172.

    Durie, B., & Stepan, D. (2001). Low dose thalidomide alone and in combination: Long term follow-up [Abstract 688]. Blood, 98, 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. Cancer, 36, 842-854.

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

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

    Gautier, M., & Cohen, H.J. (1994). Multiple myeloma in the elderly. Journal of American Geriatrics Society, 42, 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. Leukemia, 15, 1950-1961.

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

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

    He, Y., Wheatley, K., Clark, O., Glasmacher, A., Ross, H., & Djulbegovic, B. (2003). Early versus deferred treatment for early stage multiple myeloma. Cochrane Database of Systematic Reviews, 1, 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. Blood, 96, 2943-2950.

    Hussein, M. (2003). Pegylated liposomal doxorubicin, vincristine, and reduced-dose dexamethasone as first-line therapy for multiple myeloma. Clinical Lymphoma, 4(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]. Proceedings of the American Society of Clinical Oncology, 22, 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. Bone Marrow Transplantation, 34, 485-490.

    Kyle, R.A. (2002). Diagnosis and treatment of multiple myeloma in the elderly. Clinical Geriatrics, 10(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. Mayo Clinic Proceedings, 78, 21-33.

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

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

    Kyle, R.A., & Rajkumar, S.V. (2001). Therapeutic application of thalidomide in multiple myeloma. Seminars in Oncology, 28, 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. Cancer Research, 62, 5019-5026.

    Lokhorst, H. (2002). Clinical features and diagnostic criteria. In J. Mehta & S. Singhal (Eds.), Myeloma (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. American Journal of Hematology, 73, 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. Journal of Clinical Oncology, 19, 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. Clinical Journal of Oncology Nursing, 7, 403-408.

    Mehta, J. (2002). Allogeneic hematopoietic stem cell transplantation in myeloma. In J. Mehta & S. Singhal (Eds.), Myeloma (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. Proceedings of National Academy of Sciences of the United States of America, 101, 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. Proceedings of National Academy of Sciences of the United States of America, 99, 14374-14379.

    Mooberry, S.L. (2003). New insights into 2-methoxyestradiol, a promising antiangiogenic and antitumor agent. Current Opinion in Oncology, 15, 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. Seminars in Hematology, 37(Suppl. 3), 15-21.

    National Comprehensive Cancer Network. (2004). NCCN 2004 clinical practice guidelines in oncology: Multiple myeloma [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. Blood, 102, 3349-3353.

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

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

    Raje, N., & Anderson, K.C. (2002). Thalidomide and immunomodulatory drugs as cancer therapy. Current Opinion in Oncology, 14, 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]. Proceedings of the American Society of Clinical Oncology, 22, 560s.

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

    Rajkumar, S.V., & Greipp, P.R. (2002). Plasma cells and immunoglobulins. In J. Mehta & S. Singhal (Eds.), Myeloma (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. Journal of Clinical Oncology, 20, 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]. Blood, 100, 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]. Blood, 98, 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. New England Journal of Medicine, 348, 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. Blood, 100, 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. American Journal of Clinical Oncology, 25(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. Cancer, 98, 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. Lancet, 2, 882-885.

    Santucci, R., Mackley, P.A., Sebti, S., & Alsina, M. (2003). Farnesyltransferase inhibitors and their role in the treatment of multiple myeloma. Cancer Control, 10, 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. Journal of Clinical Oncology, 22, 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. Blood, 93, 51-54.

    Singhal, S. (2002). High-dose therapy and autologous transplantation. In J. Mehta & S. Singhal (Eds.), Myeloma (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. New England Journal of Medicine, 341, 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. Medical Oncology, 18, 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. Journal of Clinical Pharmacology, 43, 154-162.

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

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

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

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

    Tariman, J.D., & Lemoine, C. (2003). Bortezomib. Clinical Journal of Oncology Nursing, 7, 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. Bone Marrow Transplantation, 31, 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. European Journal of Haematology, 70, 34-42.

    Thompson, J.L., & Hansen, L.A. (2003). Thalidomide dosing in patients with relapsed or refractory multiple myeloma. Annals of Pharmacotherapy, 37, 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. Cancer Research, 63, 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. Blood, 93, 1858-1868.

    Weber, D., Rankin, K., Gavino, M., Delasalle, K., & Alexanian, R. (2003). Thalidomide alone or with dexamethasone for previously untreated multiple myeloma. Journal of Clinical Oncology, 21, 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 http://www.cro.lurie.northwestern.edu/Trials/MultipleMyeloma/MM_studies.htm

    Wong, D.L. (1995). Health promotion of the infant and family. In D. Wilson (Ed.), Nursing care of infants and children (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). Hematology Journal, 3, 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. Clinical Lymphoma, 4, 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. Clinical Therapeutics, 21, 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. Blood, 99, 1745-1757.

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