الفهرس 
Multiple myelomaOnly 14 pages are availabe for public view
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Abstract
Background: Multiple myeloma is a clonal disorder of plasma cells in which there has been great advances and modalities of therapy including autologous HSCT but non of the available modalities of treatment still curative .Adding immunomodulatory agents like clarithromycin to the protocol of treatment was assessed in this study ,in which clarithromycin was added to the protocol of treatment (either VCD or VRD) to patients diagnosed as denovo MM.
Aim of the Work: The aim of the present study is to determine the effect of adding clarithromycin in multiple myeloma patients as impact of outcome and management .
Patients and Methods: A prospective study. The study will be conducted on patients diagnosed as Multiple Myeloma (MM) attending hematology department of Ain Shams University .
In this study patients were categorized into two major groups ,group 1 including 67 cases diagnosed as MM (30 cases of them received vcd while 37 cases received vrd) in this group patients received clarithromycin added to their protocol of treatment in a dose of 250 mg every 12 hour for 21 days per month, the other group include 30 control subjects diagnosed as MM receiving their standard of care treatment protocol .
Results: In the present study we found that Patients in group 1 and 2 were almost matched as regard age and sex and there were no statistically significant P values as regard other clinical and laboratory parameters except for patients in group 2 have clinically significant incidence of ISHD as a comorbidity (P 0.033) when compared to group 1 and that’s because patients with ISHD were excluded from the trial of adding clarithromycin.
It was found that there were no statistically significant P value between group 1 and 2 as regard overall survival over 3 months and rate of remission with P value of (0.652, 0.606) respectively but there is difference in cases who take clarithromycin with VRD and who take it with VCD with remission rates 83.8 %versus 56.7% respectively
Conclusion: We conclude that no statistically significant difference between two groups as regard survival and remission rates but remission rates was higher in cases received clarithromycin plus vrd than vcd .