PhD defence B.E. (Berdien) Oortgiesen

Real-world studies of patients with multiple myeloma

This thesis describes various studies in the field of drug treatment of multiple myeloma, also known as Kahler's disease, and the complications of this condition. The investigations in this thesis were initiated within the Frisian Hemobase research group that focuses on conducting population-wide scientific research in hemato-oncology. This thesis has shown that new treatment options improved the outcomes of some multiple myeloma patients, but that some patients are still in need for more personalized treatment strategies. For example, we have found that the introduction of bortezomib in the treatment of multiple myeloma patients has a beneficial effect on dialysis dependence. On the other hand, the risk of bone fractures in this patient population is unabated high. In addition, nerve damage is a common problem that is underestimated in daily practice, and we have found an association between vitamin D deficiency and nerve damage. We have further investigated the implications of vitamin D for the use in nerve damage by designing a dosing schedule with high doses of vitamin D. Two-thirds of the study population obtained adequate vitamin D after 6 months. A significant decrease in the severity of neuropathy was observed at the end of the study period. Although these results are promising, the study was not designed to confirm the causality between vitamin D levels and PN, and further research should be undertaken to investigate the effect of vitamin D supplementation on the prevalence and severity of neuropathy in newly diagnosed patients with multiple myeloma.

Promotores Prof.dr. E.N. van Roon