Impact of adding clarithromycin in multiple myeloma patients on outcome and overall survival

Abstract

Background Clarithromycin is one of the macrolide antibiotics which was shown in some studies to enhance the effect of immunomodulatory drugs and has a synergistic effect when added to them, so we proposed in this study to add clarithromycin to the protocols of treatment of multiple myeloma (MM) patients whether velcade, cyclophosphamide, dexamethasone or velcade, lenalidomide, dexamethasone and study its effect on the rate of remission and 3 months overall survival (OS). Patients and methods To study the prognostic effect of adding clarithromycin to myeloma patients and its relation to OS. This study was conducted in Clinical Haematology and Bone Marrow Transplantation Unit, Ain Shams University Hospital, Cairo, Egypt. In this study, patients were categorized into two major groups, group 1 included 67 cases diagnosed as MM (30 cases of them received velcade, cyclophosphamide, dexamethasone and the other 37 cases received velcade, lenalidomide, dexamethasone), in this group patients received clarithromycin added to their protocol of treatment in a dose of 250 mg every 12 h for 21 days per month, the other group included 30 controls diagnosed as MM receiving their standard-of-care treatment protocols. Results It was found that there was no statistically significant P value between groups 1 and 2 as regards OS over 3 months and rate of remission with a P value of 0.652 and 0.606, respectively. Conclusion Adding clarithromycin to treatment protocols in patients with MM was of nonimportance or significance, and we suggest doing more studies and research on a large number of candidates with better assessment.