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This Journal feature begins with a case vignette that includes a therapeutic recommendation. A discussion of the clinical problem and the mechanism of benefit of this form of therapy follows. Major clinical studies, the clinical use of this therapy, and potential adverse effects are reviewed. Relevant formal guidelines, if they exist, are presented. The article ends with the authors' clinical recommendations.
A previously healthy 59-year-old man presents with persistent pain in his lower back and fatigue. A complete blood count reveals a hemoglobin level of 9.8 g per deciliter. A monoclonal protein (M component) is detected on serum protein electrophoresis
The Clinical Problem
Pathophysiology and Effect of Therapy
Clinical Evidence
Clinical Use
Adverse Effects
Areas of Uncertainty
Guidelines
Recommendations
Source Information
From the René Gauducheau Cancer Center, Nantes–Saint Herblain (J.-L.H.), and University Hospital Hôtel Dieu, Nantes (P.M.) — both in France.
Address reprint requests to Dr. Harousseau at the René Gauducheau Cancer Center, Blvd. J. Monod, 44805 Nantes–Saint Herblain, France, or at jl-harousseau@nantes.fnclcc.fr.
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