Caspian Journal of Internal Medicine

en Curcumin as adjuvant therapy to improve remission in myeloma patients: A pilot randomized clinical trial Hematology Hematology Original Article Original Article <div>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.</div> myeloma, remission, NF-κB, VEGF, TNF-α, and IL-6 375 384 http://caspjim.com/browse.php?a_code=A-10-1603-1&slc_lang=en&sid=1 Damai Santosa santosaiva@yahoo.com 100319475328460036528 100319475328460036528 Yes Division of Hematology-Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Diponegoro University/Dr. Kariadi General Hospital, Indonesia Catharina Suharti hemasemarang@gmail.com 100319475328460036529 100319475328460036529 No Division of Hematology-Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Diponegoro University/Dr. Kariadi General Hospital, Indonesia Ignatius Riwanto iriwanto@gmail.com 100319475328460036530 100319475328460036530 No Department of Surgery, Faculty of Medicine, Diponegoro University, Indonesia Edi Dharmana edidharmana@yahoo.com 100319475328460036531 100319475328460036531 No Department of Parasitology, Faculty of Medicine, Diponegoro University, Indonesia Eko Adhi Pangarsa ekopangarsa90@gmail.com 100319475328460036532 100319475328460036532 No Division of Hematology-Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Diponegoro University/Dr. Kariadi General Hospital, Indonesia Budi Setiawan boedhi_smg73@yahoo.com 100319475328460036533 100319475328460036533 No Division of Hematology-Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Diponegoro University/Dr. Kariadi General Hospital, Indonesia Suyono Suyono 100319475328460036534 100319475328460036534 No Division of Hematology-Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Diponegoro University/Dr. Kariadi General Hospital, Jawa Tengah, Indonesia Mika Lumban Tobing hemasemarang@yahoo.com 100319475328460036535 100319475328460036535 No Division of Hematology-Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Diponegoro University/Dr. Kariadi General Hospital, Indonesia Suhartono Suhartono santosaiva@yahoo.com 100319475328460036536 100319475328460036536 No Department of Environmental Health, Faculty of Public Health, Diponegoro University, Jawa Tengah, Indonesia Soeharyo Hadisaputro prof_haryo@yahoo.co.id 100319475328460036537 100319475328460036537 No Division of Topical and Infectious Disease, Department of Internal Medicine, Faculty of Medicine, Diponegoro University, Indonesia