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Genetic Diagnosis: DNA Microarrays and Cancer

Thalidomide and multiple myeloma In the past few years, thalidomide has begun to impact on the treatment of multiple myeloma (MM; BOX 2). This is an incurable B-cell malignancy in which increased bone-marrow microvessel density (MVD) is associated with poor prognostic outcome, providing the rationale for treatment with thalidomide. Remarkably, an initial report published in 1999 indicated that thalidomide was an effective treatment in 30–40% of patients with advanced and refractory MM28 and showed that, of the 84 patients treated, there was an overall clinical response rate of 32%. Moreover, 10% of patients had complete, or near complete, remissions. Partial remission — defined by a >50% decrease in serum or urine monoclonal protein, an established prognostic indicator — was achieved in 25% of patients. The authors of this study were unable to show an association between the clinical response to thalidomide and a decrease in bone-marrow MVD. However, very recent data showing decreased MVD only in patients who responded to thalidomide does support the theory that angiogenesis is a