**Author details**

High-dose chemotherapy in association with autologous transplantations using bone mar‐ row or blood-derived stem cells is now widely accepted for the treatment of hematological malignancies including MM. This approach yielded to complete remissions in refractory hu‐ man patients, but mortality rate due to bone marrow suppression was high. Contamination of most bone marrow and blood stem cell samples with neoplastic cells within the auto‐ graph resulted in recurrence of disease, emphasizing the need of optimize purging techni‐ ques [246-250]. Autologous bone marrow transplant has also been added to chemotherapy in the treatment of some malignancies in companion animals, such as lymphoma and acute

In human patients with MM, biphosphonates such as pamidronate, have been used to pre‐ vent or to delay the onset of bone lesions and associated bone pain [254-257]. Bisphospho‐ nates have been administered in dogs with appendicular osteosarcoma [258-259] and with malignant histiocytosis [260], but they have not been used in veterinary patients with MM. Treatment of patients affected by indolent MM with the anti-angiogenic agent thalidomide resulted in a 66% response rate and the drug appeared to have potential to delay the onset of clinical signs associated with the disease [261-262]. The efficacy of thalidomide for the treatment of refractory relapsed MM has also been confirmed [263-265]. Studies evaluating the possible efficacy of thalidomide for the treatment of MM in companion animals are lack‐ ing. Bortezomib, a proteasome inhibitor, induces apoptosis of MM cells and inhibits their binding to bone marrow stromal cells, which otherwise would trigger the transcription of interleukin-6 via an NFκB-dependent pathway. In different studies a 25% response rate was achieved in human beings with MM and an overall survival time of 16 months. Further‐ more, addition of dexamethasone to the treatment regimen improved responses in 19% of

Additional, some patients experience severe clinical signs secondary to hypercalcemia, renal dysfunction, HVS or pathologic fractures will require palliative therapy specifically directed

Unfortunately, the prognosis of companion animals with MM is poor. The mean survival time in dogs treated with MM and treated with melphalan, cyclophosphamide and predni‐ sone is 540 days after diagnosis [27]. In dogs, negative prognostic factors include extensive bone lesions, hypercalcemia and light chain proteinuria. Renal insufficiency and poor initial response to therapy also may be associated with decreased survival times [27]. In a study of 9 cats with MM, it was found that hypercalcemia, pathologic fractures, anemia, Bence-Jones proteinuria, azotemia, persistent elevations in serum protein concentrations at 8 weeks after treatment and little or no clinical improvement were poor prognostic indicators and reflect‐ ed a more aggressive form of the disease [29]. Survival time for such cats did not exceed 14 days, with a median of 5 days. In contrast, normocalcemia, lack of azotemia, absence of pathologic fractures, no anemia, absence of Bence-Jones proteinuria and a normal serum

**7. Prognosis of companion animals with multiple myeloma**

myeloid leukemia [251-253].

304 Multiple Myeloma - A Quick Reflection on the Fast Progress

treated patients [227-228,264,266].

to the clinical complications of the disease.

A. Muñoz1 , C. Riber1 , K. Satué2 , P. Trigo3 , M. Gómez-Díez3 and F.M. Castejón3

\*Address all correspondence to: pv1mujua@uco.es

1 Department of Animal Medicine and Surgery, School of Veterinary Medicine, University of Córdoba, Córdoba, Spain

2 Department of Animal Medicine and Surgery, School of Veterinary Medicine, Cardenal Herrera-CEU University, Valencia, Spain

3 Equine Sport Medicine Centre, School of Veterinary Medicine, University of Córdoba, Cór‐ doba, Spain

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