Multiple Myeloma: Treatment is Getting Individualized
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Multiple myeloma (MM) is a heterogeneous disease with varied outcome. The novel agents including two major classes of drugs; the immunomodulatory drugs and the proteasome inhibitors with unprecedented response rates, have replaced conventional chemotherapy. With monoclonal antibodies on the horizon, outcome of this disorder will further improve. Progression in risk stratification systems has made it possible to predict the disease course as well as outcome in myeloma patients with disease categorization into low to high risk. In addition, detection of minimal residual disease by serum free light chain assay, flow cytometry, molecular techniques like polymerase chain reaction and positron emission tomography scan is playing an important role in modifying the treatment. An extensive research in the disease biology has improved our knowledge regarding interplay between myeloma cells and elements of the bone marrow microenvironment which contribute to sustain proliferation and survival as well as de novo drug resistance. Again, insight into the role of genetic and epigenetic interactions in MM has exposed new molecular targets. All these have opened the gateway for novel therapeutic strategies with focus on risk based individualized therapy.
KeywordsMyeloma Personalized Treatment Risk Stratification Novel
Professional medical writing support and editorial assistance was provided by DiagnoSearch Life Sciences (P) Ltd., funded by Bristol-Myers Squibb.
Compliance with Ethical Standards
Conflict of Interest
The author did not receive financial compensation for authoring the manuscript.
- 2.Kumar SK, Mikhael JR, Buadi FK, Dingli D, Dispenzieri A, Fonseca R et al (2009) Management of newly diagnosed symptomatic multiple myeloma: updated mayo stratification of myeloma and risk-adapted therapy (mSMART) consensus guidelines. Mayo Clin Proc 84(12):1095–1110PubMedCentralCrossRefPubMedGoogle Scholar
- 3.Ghalaut PS, Chaudhuri S, Singh R (2013) Recent advances in diagnosis and management of multiple myeloma: an update. In: The Association of Physicians of India, Medicine Update 2013, Section 10 Hematology, Chapter 80, pp 360–365Google Scholar
- 4.Ries LAG, Melbert D, Krapcho M, Mariotto A, Miller BA, Feuer EJ, et al (2007) SEER Cancer Statistics Review, 1975–2004. National Cancer Institute, Bethesda [online]. Available from http://seer.cancer.gov/csr/1975_2004/. Accessed Nov 2012
- 5.Programme National Cancer Registry (2005) Two year report of the population based cancer registries 1999–2000. Indian Council of Medical Research, New DelhiGoogle Scholar
- 22.Bladé J, Sonneveld P, San Miguel JF, Sutherland HJ, Hajek R, Nagler A et al (2011) Efficacy and safety of pegylated liposomal doxorubicin in combination with bortezomib for multiple myeloma: effects of adverse prognostic factors on outcome. Clin Lymphoma Myeloma Leuk 11(1):44–49CrossRefPubMedGoogle Scholar
- 32.Puente PDL, Muz B, Azab F, Luderer M, Azab AK (2014) Molecularly targeted therapies in multiple myeloma. Hindawi Publishing Corporation Leukemia Research and Treatment, Article ID 976567. doi: 10.1155/2014/976567
- 45.Kroger N, Badbaran A, Zabelina T, Ayuk F, Wolschke C, Alchalby H et al (2013) Impact of high-risk cytogenetics and achievement of molecular remission on long-term freedom from disease after autologous-allogenic tandem transplantation in multiple myeloma. Biol Blood Marrow Transpl 19:398–404CrossRefGoogle Scholar
- 47.Fouquet G, Bories C, Guidez S, Renaud L, Herbaux C, Javed S et al (2014) Expert reviews pomalidomide for multiple myeloma. Expert Rev Hematol. Early online, 1–13 (2014). Available from: http://szpiczak.org/lang/aktualnosci/komunikaty/pdf/rok_2014/17474086_2014_966074.pdf
- 50.Xie Z, Chng WJ (2014) MMSET: role and therapeutic opportunities in multiple myeloma. BioMed Res Int, Article ID 636514Google Scholar
- 52.Dimopoulos MA, Kastritis E, Christoulas D, Migkou M, Gavriatopoulou M, Gkotzamanidou M et al (2010) Treatment of patients with relapsed/refractory multiple myeloma with lenalidomide and dexamethasone with or without bortezomib: prospective evaluation of the impact of cytogenetic abnormalities and of previous therapies. Leukemia 24(10):1769–1778CrossRefPubMedGoogle Scholar
- 60.Hanamura I, Stewart JP, Huang Y, Zhan F, Santra M, Sawyer JR et al (2006) Frequent gain of chromosome band 1q21 in plasma-cell dyscrasias detected by fluorescence in situ hybridization: incidence increases from MGUS to relapsed myeloma and is related to prognosis and disease progression following tandemstem-cell transplantation. Blood 108:1724–1732PubMedCentralCrossRefPubMedGoogle Scholar