Bortezomib is used in the treatment of? (LQ)
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.
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
Local irradiation for bone pain, pathological fractures and tumorous lesions.
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.
Conditions with decreased ESR
3. Sickle cell anemia
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