ASH evidence-based guidelines: what is the role of maintenance therapy in the treatment of multiple myeloma?
A 51-year-old male was diagnosed with an IgA multiple myeloma (MM) after having back pain for several months. His bone marrow showed 30% involvement with plasma cells and his cytogenetics showed t(4:14). His beta2-microglobulin was 6.5 mg/dL at diagnosis and he had multiple lytic lesions, along with a creatinine of 2.3 mg/dL and significant anemia. Induction therapy with lenalidomide, bortezomib and dexamethasone was used, and he was able to achieve complete remission after 4 cycles of therapy. He then went on to receive high-dose chemotherapy with a single autologous stem cell transplant. He tolerated it well and now comes to discuss follow-up treatment plans. He wants to discuss maintenance therapy.
Ghobrial
Irene M
IM
Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
Stewart
A Keith
AK
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001897:Boronic Acids / Q000008:administration & dosage; D000069286:Bortezomib; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D003131:Combined Modality Therapy; D003907:Dexamethasone / Q000008:administration & dosage; D019317:Evidence-Based Medicine; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D016898:Interferon-alpha / Q000008:administration & dosage; D000077269:Lenalidomide; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000601:surgery; D017410:Practice Guidelines as Topic; D011719:Pyrazines / Q000008:administration & dosage; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D012074:Remission Induction; D013792:Thalidomide / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use
D001897:Boronic Acids; D007155:Immunologic Factors; D016898:Interferon-alpha; D011719:Pyrazines; D013792:Thalidomide; D000069286:Bortezomib; D003907:Dexamethasone; D000077269:Lenalidomide