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Medicine

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Hematology

Question
23 out of 29
 

Bortezomib is used in the treatment of? (LQ)



A AML
B ALL

C MM
D CML

Ans. C

MM

Management

1. Patients should be given at least 3 liters of fluid daily to preserve normal renal function.

2. Pamidronate 15 – 30 mg slow IV infusion helps in lowering serum calcium.

3. Allopurinol 300mg orally daily to prevent excessive formation of uric acid.

4. Chemotherapy

Adriamycin, BCNU, cyclophosphamide and melphalan in 6 weeks pulses achieves best results.

5. Alpha – 2 interferon.

6. Autologous bone marrow transplantation for resistant cases is also under evaluation

7. Radiotherapy:

Local irradiation for bone pain, pathological fractures and tumorous lesions.

Newer drugs.

1. Thalidomide

2. Bortezomib (Proteosome inhibitor)

Recent Advances - New Drugs:

a. Amifostine: Cancer chemotherapy produces a wide variety of side effects many of which are disabling. Amifostine is a free radical scavenger that is used to reduce such side effects. It most important therapeutic use is to act as a cytoprotective agent for treatment of alkylating agent-induced cytotoxicity.

b. Bortezomib: Existing therapeutic options for multiple myeloma include agents such as thalidomide, bortezomib, and lenalidomide, either used alone or in combination with standard agents, including glucocorticoids, and in conjunction with high-dose chemotherapy supported with stem cell transplantation. Bortezomib is a proteasome inhibitor.

Extra Edge:

Conditions with decreased ESR

1. Polycythemia

2. CHF

3. Sickle cell anemia

4. Afibrinogenemia

Conditions with increased ESR that need to be remembered:

1. Multiple myeloma

2. Anemia other than sickle cell

3. Giant cell arteritis

4. De Quervain thyroiditis

Hematology Flashcard List

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