Management of newly diagnosed myeloma.
The treatment of multiple myeloma has changed dramatically in the last decade with the introduction of thalidomide, bortezomib, and lenalidomide. Patients eligible for autologous stem cell transplantation (ASCT) are treated with non-alkylating agent-containing regimens as initial therapy; typically thalidomide-dexamethasone or lenalidomide-dexamethasone. For patients not eligible for ASCT, the current standard of care is melphalan, prednisone, and thalidomide. Ongoing trials will soon assess if combinations including melphalan and prednisone plus bortezomib or MP plus lenalidomide may be considered an attractive option. Patients who have risk factors, such as deletion 13 or translocation t(4;14) or t(14;16), are candidates for novel, more aggressive treatments.
Rajkumar
S Vincent
SV
Division of Hematology, Department of Internal Medicine, Mayo Clinic and Foundation, College of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. rajks@mayo.edu
Palumbo
Antonio
A
D000367:Age Factors; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008875:Middle Aged; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000175:diagnosis / Q000188:drug therapy*; D009101:Multiple Myeloma / Q000175:diagnosis / Q000188:drug therapy*; D019653:Myeloablative Agonists / Q000627:therapeutic use; D011379:Prognosis; D014182:Transplantation, Autologous
D000970:Antineoplastic Agents; D019653:Myeloablative Agonists