:: Volume 13, Issue 2 (Spring 2022) ::
Caspian J Intern Med 2022, 13(2): 375-384 Back to browse issues page
Curcumin as adjuvant therapy to improve remission in myeloma patients: A pilot randomized clinical trial
Damai Santosa * , Catharina Suharti , Ignatius Riwanto , Edi Dharmana , Eko Adhi Pangarsa , Budi Setiawan , Suyono Suyono, Mika Lumban Tobing , Suhartono Suhartono , Soeharyo Hadisaputro
Division of Hematology-Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Diponegoro University/Dr. Kariadi General Hospital, Indonesia , santosaiva@yahoo.com
Abstract:   (2073 Views)
Background: The treatment for ineligible transplant multiple myeloma is melphalan prednisone. Curcumin has an anti-inflammatory and antiangiogenesis in cancer-directed to nuclear factor-kappa B (NF-kB) pathway. Interleukin 6 (IL-6), vascular endothelial growth factor  (VEGF), tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP), and lactate dehydrogenase (LDH) were also involved in the pathogenesis of myeloma. No clinical study has evaluated the efficacy of curcumin in myeloma patients.To evaluate the efficacy of curcumin as adjuvant into melphalan prednisone in myeloma patients
Methods: 33 myeloma patients at Dr. Kariadi General Hospital, Semarang, Indonesia during 2016-2017 were randomly assigned single-blindedly into MPC (n=17) and control group (n=16). The MPC group was treated with melphalan 4 mg/m2, prednisone 40 mg/m2 for 7 days, and curcumin 8 gram daily for 28 days. The MP control group was treated with melphalan, prednisone, and placebo. The primary endpoint was the overall remission.  Pre- and post-treatment was examined for NF-κB, VEGF, TNF-α, IL-6, LDH, and  CRP levels All data analyses were per protocol.
Results: There was a significant difference in overall remission between the MPC and MP control groups [75%vs 33.3%, x2=6.89, P=0.009]. A significant decrease of NF-κB, VEGF, TNF-α levels were shown in the MPC group compared with the MP control group. There was a significant decrease in IL-6 levels in a subgroup analysis of the MPC group. TNF-α levels had a significant correlation with remission [OR=1.35; (95%CI=1.03-1.76); P=0.03]. 
Conclusion: Curcumin has an efficacy in improving overall remission and decreasing NF-κB, VEGF, TNF-α, and IL-6 levels in myeloma patients.
Keywords: myeloma, remission, NF-κB, VEGF, TNF-α, and IL-6
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Type of Study: Original Article | Subject: Hematology
Received: 2019/11/9 | Accepted: 2020/08/17 | Published: 2022/02/2

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Volume 13, Issue 2 (Spring 2022) Back to browse issues page