title: Multiple myeloma.
abstract: Multiple myeloma is a malignant disease characterised by proliferation of clonal plasma cells in the bone marrow and typically accompanied by the secretion of monoclonal immunoglobulins that are detectable in the serum or urine. Increased understanding of the microenvironmental interactions between malignant plasma cells and the bone marrow niche, and their role in disease progression and acquisition of therapy resistance, has helped the development of novel therapeutic drugs for use in combination with cytostatic therapy. Together with autologous stem cell transplantation and advances in supportive care, the use of novel drugs such as proteasome inhibitors and immunomodulatory drugs has increased response rates and survival substantially in the past several years. Present clinical research focuses on the balance between treatment efficacy and quality of life, the optimum sequencing of treatment options, the question of long-term remission and potential cure by multimodal treatment, the pre-emptive treatment of high-risk smouldering myeloma, and the role of maintenance. Upcoming results of ongoing clinical trials, together with a pipeline of promising new treatments, raise the hope for continuous improvements in the prognosis of patients with myeloma in the future.
authors.affiliation: Medizinische Klinik und Poliklinik I, Universitätsklinikum, Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany. Electronic address: christoph.roellig@uniklinikum-dresden.de.
authors.forename: Christoph
authors.initials: C
authors.lastname: Röllig
authors.affiliation: Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg, Würzburg, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Knop
authors.affiliation: Medizinische Klinik und Poliklinik I, Universitätsklinikum, Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Bornhäuser
mesh_terms: D001853:Bone Marrow / Q000503:physiopathology; D016026:Bone Marrow Transplantation / Q000379:methods; D003131:Combined Modality Therapy / Q000379:methods*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D056747:Immunomodulation; D009101:Multiple Myeloma / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D010950:Plasma Cells / Q000502:physiology; D011379:Prognosis; D061988:Proteasome Inhibitors / Q000627:therapeutic use
chemical_list: D007155:Immunologic Factors; D061988:Proteasome Inhibitors