Velcade can prolong life for two to three years

The National Institute for Health and Clinical Excellence said the value of Velcade, a drug that slows the progression of myeloma, was unclear.

Around 4,000 are diagnosed with the cancer in the UK each year.

Campaigners have condemned NICE's initial decision, which applies to patients in England and Wales.

Myeloma is the Cinderella of cancers Professor Gareth Morgan

NICE, which regulates medicines for use in the NHS in England and Wales, is currently appraising Velcade, also known Bortezomib, for treatment of myeloma, also known as multiple myeloma which affects plasma cells in bone marrow.

The cancer accounts for about 2% of all cancer cases in the UK, and has poor survival rates, with only 23% of patients living for more than five years after diagnosis.

The drugs makers say the treatment is most effective for patients who have already been treated for myeloma, using chemotherapy and other drugs such as thalidomide, but have suffered a relapse.

They say it can prolong life by 18 to 24 months and reduce the incidence of associated diseases such as anaemia.

Treatment would cost about �18,000 per patient.

'Death sentence'

But NICE has provisionally said that the drug should only be used for patients in clinical studies.

Andrea Sutcliffe, the head of appraisal at NICE, said it had been decided that the drug's role in the treatment of multiple myeloma was "uncertain and needed to be established more clearly with more research "before it can be recommended for general use in the NHS".

Velcade is currently being prescribed in England and Wales, prior to NICE's final recommendations.

Scotland and Northern Ireland have already approved the drug and are using it, and it is licensed in Europe and in other areas of the world.

But myeloma sufferers have condemned the draft recommendation and the International Myeloma Foundation (IMF) said that, if it became final, it would be "ill-informed, unjust and unfair".

Malcolm Cole, a patient from Oxfordshire who is waiting for access to the drug, said: "It seems ridiculous that there is a drug that could keep me alive but NICE don't believe I should be entitled to it.

"A judge is not allowed to pass a death sentence on a murderer, but it seems NICE can pass a death sentence on anyone in the national health."

Professor Gareth Morgan, professor of haematology at the Royal Marsden Hospital in London and president of IMF (UK), said: "Myeloma is the Cinderella of cancers. It doesn't receive anywhere near the same level of funding that other cancers do.

"The evidence suggests both clinically and cost effectively that Velcade is best used at first relapse - there is no other licensed treatment in this area - we absolutely need this drug approved."