title: Treatment for patients with newly diagnosed multiple myeloma in 2015.
abstract: Multiple myeloma is the second most frequent haematological disease. The introduction of high-dose melphalan followed by autologous haematopoietic cell transplant (HDT/ASCT) for young patients and the availability of novel agents for young and elderly patients with multiple myeloma have dramatically changed the perspective of treatment. However, further research is necessary if we want to definitively cure the disease. Treatment goals for transplant-eligible and non-transplant-eligible patients should be to prolong survival by achieving the best possible response, while ensuring quality of life. The treatment should be individualized on the basis of host and disease features and better monitoring of the response upon use of high-sensitivity techniques for evaluating residual disease. For young patients, HDT/ASCT is a standard of care for treatment and its efficacy has been enhanced and challenged by the new drugs. For elderly patients, treatment options were limited to alkylators, but new upfront treatment combinations based on novel agents (proteasome inhibitors and immunomodulatory drugs) combined or not with alkylators have significantly improved outcomes.Extended treatment for young and elderly patients improves the quality and duration of clinical responses; however,the optimal scheme, appropriate doses and duration of long-term therapy have not yet been fully determined.This review summarises the progress in the treatment of patients with newly diagnosed multiple myeloma, addressing critical questions such as the optimal induction, early versus late ASCT, consolidation and/or maintenance for young patients, and how we can choose the best option for non-transplant-eligible patients.
authors.affiliation: Hospital Universitario de Salamanca-IBSAL, IBMCC-CSIC, Salamanca, Spain. Electronic address: mvmateos@usal.es.
authors.forename: María-Victoria
authors.initials: MV
authors.lastname: Mateos
authors.affiliation: Hospital Universitario de Salamanca-IBSAL, IBMCC-CSIC, Salamanca, Spain.
authors.forename: Enrique M
authors.initials: EM
authors.lastname: Ocio
authors.affiliation: Clínica Universidad de Navarra/Centro de Investigación Médica Aplicada (CIMA), Spain.
authors.forename: Bruno
authors.initials: B
authors.lastname: Paiva
authors.affiliation: Hospital Clínic i Provincial de Barcelona, Institut d'Investigacions Biomédiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Rosiñol
authors.affiliation: Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Joaquín
authors.initials: J
authors.lastname: Martínez-López
authors.affiliation: Hospital Clínic i Provincial de Barcelona, Institut d'Investigacions Biomédiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Bladé
authors.affiliation: Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Juan-José
authors.initials: JJ
authors.lastname: Lahuerta
authors.affiliation: Hospital Universitario de Salamanca-IBSAL, IBMCC-CSIC, Salamanca, Spain.
authors.forename: Ramón
authors.initials: R
authors.lastname: García-Sanz
authors.affiliation: Clínica Universidad de Navarra/Centro de Investigación Médica Aplicada (CIMA), Spain.
authors.forename: Jesús F
authors.initials: JF
authors.lastname: San Miguel
mesh_terms: D000367:Age Factors; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000069286:Bortezomib / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003907:Dexamethasone / Q000627:therapeutic use; D004334:Drug Administration Schedule; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D000077269:Lenalidomide; D008558:Melphalan / Q000627:therapeutic use; D009101:Multiple Myeloma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D057285:Precision Medicine; D016019:Survival Analysis; D013792:Thalidomide / Q000031:analogs & derivatives / Q000627:therapeutic use; D019172:Transplantation Conditioning / Q000379:methods*; D014182:Transplantation, Autologous
chemical_list: D013792:Thalidomide; D000069286:Bortezomib; D003907:Dexamethasone; D000077269:Lenalidomide; D008558:Melphalan
keywords: Multiple myeloma; Newly diagnosed; Upfront treatment