Mediterranean Journal of Hematology and Infectious Diseases (May 2010)

THE TREATMENT OF MULTIPLE MYELOMA PATIENTS NOT ELIGIBLE FOR ASCT

  • Anuj Mahindra,
  • Jacob Laubach,
  • Paul Richardson,
  • Constantine Mitsiades,
  • Robert Schlossman,
  • Irene Ghobrial,
  • Teru Hideshima,
  • Noopur Raje,
  • Nikhil Munshi,
  • Kenneth Anderson

Journal volume & issue
Vol. 2, no. 2
pp. e2010009 – e2010009

Abstract

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<p class="MsoNormal" style="margin: 0cm 0cm 0pt; line-height: 150%; mso-layout-grid-align: none;"><span style="font-size: small;"><span style="font-family: ";Arial";,";sans-serif";; mso-ansi-language: EN-GB; mso-fareast-language: EN-GB;" lang="EN-GB">Advances in therapies for younger patients with multiple myeloma have resulted in significant</span><strong style="mso-bidi-font-weight: normal;"><span style="font-family: ";Arial";,";sans-serif";; mso-ansi-language: EN-GB;" lang="EN-GB"> </span></strong><span style="color: black; font-family: ";Arial";,";sans-serif";; mso-ansi-language: EN-GB; mso-fareast-language: EN-GB;" lang="EN-GB">improvements in outcome over recent years,</span><span style="font-family: ";Arial";,";sans-serif";; mso-ansi-language: EN-GB; mso-fareast-language: EN-GB;" lang="EN-GB"> on the contrary the<span style="color: black;"> progress in treatments for elderly patients has remained more modest. Traditionally, patients <span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>who are not eligible for transplantation, like the older patients, <span style="mso-spacerun: yes;"> </span>have been treated with the combination of melphalan plus prednisone (MP), which leads to responses in approximately 50% of patients; however, patients rarely achieve a complete response (CR) and long-term outcomes are disappointing, with a relapse-free survival of approximately 18 months and an overall survival (OS) of approximately 3 years.</span></span></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt; line-height: 150%; mso-layout-grid-align: none;"><span style="color: black; font-family: ";Arial";,";sans-serif";; mso-ansi-language: EN-GB; mso-fareast-language: EN-GB;" lang="EN-GB"><span style="font-size: small;">With the arrival of novel agents, including the first–in-class proteasome inhibitor, bortezomib, and the immunomodulatory agents, thalidomide and lenalidomide, a shift in the management of older patients and/or those not eligible for transplantation has taken place. Increasingly, novel agents are now being incorporated into therapy, based on the positive findings from clinical trials in this setting, and outcomes have improved accordingly.</span></span></p>

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