title: The Diagnosis and Treatment of Multiple Myeloma.
abstract: BACKGROUND
  Multiple myeloma is a malignant disease of plasma cells with a worldwide incidence of 6-7 cases per 100 000 persons per year. It is among the 20 most common types of cancer in Germany.
  
  
  METHODS
  This review is based on pertinent publications up to December 2015 that were retrieved by a selective search of PubMed employing the terms "multiple myeloma" AND "therapy" OR "diagnostic." Systematic reviews, meta-analyses, randomized controlled trials, and treatment recommendations from Germany and abroad were considered.
  
  
  RESULTS
  The diagnostic evaluation of multiple myeloma comprises thorough history-taking and physical examination, various laboratory tests including analysis of a 24-hour urine sample, a bone-marrow biopsy, and skeletal radiography. Systemic treatment should be administered only when organ damage has been diagnosed. The type of treatment to be given is chosen individually on the basis of the patient's age, comorbidities, and risk profile. High-dose therapy with autologous stem-cell transplantation remains the treatment of choice for patients under age 70 who are otherwise in good health. For patients who are not candidates for high-dose therapy or who have had a recurrence of multiple myeloma after prior high-dose therapy, there are a number of further conventional treatment options. Patients need not only systemic antineoplastic treatment, but also supportive treatment for the prevention of treatment-induced toxicity and myeloma-associated organ damage.
  
  
  CONCLUSIONS
  Recent therapeutic advances have made the treatment of multiple myeloma both more complex and more costly. In particular, the median survival of patients with multiple myeloma has been markedly prolonged through the use of targeted drugs such as proteasome inhibitors and immune modulators.
authors.affiliation: Department of Hematology, Oncology, Tumor Immunology, and Palliative Medicine, Helios Hospital Berlin- Buch, Berlin, Department of Medicine II, Würzburg University Hospital, Würzburg.
authors.forename: Christian
authors.initials: C
authors.lastname: Gerecke
authors.forename: Stephan
authors.initials: S
authors.lastname: Fuhrmann
authors.forename: Susanne
authors.initials: S
authors.lastname: Strifler
authors.forename: Martin
authors.initials: M
authors.lastname: Schmidt-Hieber
authors.forename: Hermann
authors.initials: H
authors.lastname: Einsele
authors.forename: Stefan
authors.initials: S
authors.lastname: Knop
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D019411:Clinical Laboratory Techniques / Q000379:methods*; D003952:Diagnostic Imaging / Q000379:methods*; D019317:Evidence-Based Medicine; D005820:Genetic Testing / Q000379:methods*; D006801:Humans; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000235:genetics / Q000628:therapy*; D033581:Stem Cell Transplantation / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents