Introduction

Multiple myeloma, anemia, MM, renal insufficiency
MULTIPLE MYELOMA, BONE DESTRUCTION, ANEMIA, RENAL INSUFFICIENCY
Multiple myeloma (MM) is a plasma cell malignancy that is characterized by the accumulation of clonal plasma cells, mainly in the bone marrow, leading to clinical manifestations such as anemia, bone destruction, and renal insufficiency [Corticosteroids, and in particular dexamethasone, are an important mainstay in the treatment of MM [Dexamethasone exerts its beneficial effect in MM in several ways. Besides acting on plasma cells directly at the level of growth inhibition and induction of apoptosis [We postulate that the therapeutic value of dexamethasone in MM may be increased by utilizing the concept of nanomedicine-based drug delivery to MM bone marrow lesions. A graphical comparison of the advantage of this concept in comparison with free dexamethasone administration is given in Fig. Schematic representation of the difference between conventional oral dexamethasone treatment and intravenously infused PEG-liposomal dexamethasone, emphasizing particularly the striking difference in PK profiles and target site accumulation obtained after liposomal treatment [An important advantage of using PEG-liposomes over other drug delivery systems is that they are well established in the clinic, with proven therapeutic value and a fully investigated safety profile. Several products based on PEG-liposomes are clinically used or under investigation [We here report the results of an exploratory phase 1 clinical study (