The effect of angiogenesis inhibitors in the treatment of malignant blood disorders

Angiogenesis is recognised as amajor factor in the development of solid tumours and it is only recently that similar mechanisms have been described in haematological neoplasms. Expression of angiogenic peptides such as vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) is closely correlated with clinical aspects of large cell non-Hodgkin lymphoma (NHL). Inmultiple myeloma, microvessel density (MVD) is an independent marker for overall survival. These results have encouraged not only the development of drugs, such as lenalidomide, capable of blocking proangiogenic cytokines indiscriminately, but also that of more specific anti-VEGF agents. This reviewdiscusses current knowledge of angiogenesis, its physiological aspects and implications in the treatment of haematological neoplasms. Combination chemotherapy incorporating these novel drugs to obtain optimal responses as well as their use within stem-cell therapy remains to be discussed.