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Maintenance Therapy in Multiple Myeloma

  • Jonathan L. Kaufman
  • Ronald Mihelic
  • Sagar Lonial
Part of the Contemporary Hematology book series (CH)

Introduction

Maintenance therapy has long been an essential component of treatment for patients with hematologic malignancies. Maintenance therapy is defined as prolonged therapy delivered at regular intervals after remission induction.1 The goals of maintenance therapy are dependent on the underlying disease. Multidrug, long-term conventional chemotherapy as maintenance has been well established as an integral part of therapy to increase the cure rate in patients with acute lym-phoblastic leukemia.2 However, the goal of maintenance therapy is different in patients with follicular lymphoma. In patients with follicular lymphoma, a disease characterized by long median survival and invariable relapse, the goal of maintenance therapy is to prolong disease-free survival while minimizing the toxicity of the maintenance therapy.3The goal of maintenance therapy for myeloma should, at a minimum, be to prolong remission duration with minimal toxicity. But the ultimate goal of maintenance...

Keywords

Overall Survival Maintenance Therapy Follicular Lymphoma Maintenance Strategy Autologous Hematopoietic Stem Cell Transplantation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Mihelic R, Kaufman JL, Lonial S. Maintenance therapy in multiple myeloma. Leukemia. 2007;21(6):1150–1157.PubMedCrossRefGoogle Scholar
  2. 2.
    Faderl S, Jeha S, Kantarjian HM. The biology and therapy of adult acute lymphoblastic leukemia. Cancer. 2003;98:1337–1354.PubMedCrossRefGoogle Scholar
  3. 3.
    Berinstein NL. Principles of maintenance therapy. Leuk Res. 2006;30(Suppl. 1): S3–S10.PubMedCrossRefGoogle Scholar
  4. 4.
    Dispenzieri A, Rajkumar SV, Gertz MA, et al. Treatment of newly diagnosed multiple myeloma based on Mayo stratification of myeloma and risk-adapted therapy (mSMART): Consensus statement. Mayo Clin Proc. 2007;82:323–341.PubMedCrossRefGoogle Scholar
  5. 5.
    Interferon as therapy for multiple myeloma: An individual patient data overview of 24 randomized trials and 4012 patients. Br J Haematol. 2001;113:1020–1034.CrossRefGoogle Scholar
  6. 6.
    Fritz E, Ludwig H. Interferon-alpha treatment in multiple myeloma: Meta-analysis of 30 randomised trials among 3948 patients. Ann Oncol. 2000;11:1427–1436.PubMedCrossRefGoogle Scholar
  7. 7.
    Berenson JR, Crowley JJ, Grogan TM, et al. Maintenance therapy with alternate-day prednisone improves survival in multiple myeloma patients. Blood. 2002;99: 3163–3168.PubMedCrossRefGoogle Scholar
  8. 8.
    Alexanian R, Weber D, Giralt S, Delasalle K. Consolidation therapy of multiple myeloma with thalidomide-dexamethasone after intensive chemotherapy. Ann Oncol. 2002;13:1116–1119.PubMedCrossRefGoogle Scholar
  9. 9.
    Stewart AK, Chen CI, Howson-Jan K, et al. Results of a multicenter randomized phase II trial of thalidomide and prednisone maintenance therapy for multiple myeloma after autologous stem cell transplant. Clin Cancer Res. 2004;10:8170–8176.PubMedCrossRefGoogle Scholar
  10. 10.
    Feyler S, Graham J, Rawstron A, EL-Sherbiny Y, Snowden J, Johnson R. Thalidomide maintenance following high dose therapy in multiple myeloma: A UK Myeloma Forum Phase 2 Study. Blood. 2003;102:Abstract #2558.Google Scholar
  11. 11.
    Feyler S, Rawstron A, Jackson G, Snowden J, Hawkins K, Johnson RJ. Thalidomide maintenance following high dose therapy in multiple myeloma: a UK Myeloma Forum phase 2 study. ASH Annual Meeting Abstracts. Blood. 2003;106:641–691a.Google Scholar
  12. 12.
    Brinker BT, Waller EK, Leong T, Heffner LT, Redei I, Langston AA, Lonial S. Maintenance therapy with thalidomide improves overall survival after autologous hematopoietic progenitor cell transplantation for multiple myeloma. Cancer. 2006;106:2171–2180.PubMedCrossRefGoogle Scholar
  13. 13.
    Attal M, Harousseau JL, Leyvraz S, et al. Maintenance therapy with thalidomide improves survival in patients with multiple myeloma. Blood. 2006;108:3289–3294.PubMedCrossRefGoogle Scholar
  14. 14.
    Spencer A, Prince M, Roberts AW, Bradstock KF, Prosser IW. First analysis of the Australasian Leukaemia and Lymphoma Group (ALLG) trial of thalidomide and alternate day prednisolone following autologous stem cell transplantation (ASCT) for patients with multiple myeloma (ALLG MM6). ASH Annual Meeting Abstracts. 2006;108:58–77a.Google Scholar
  15. 15.
    Spencer AP, Prince M, Roberts AW, Bradstock KF, Prosser IW. Thalidomide improves survival when used following ASCT. Haematologica. 2007;92:41–42.CrossRefGoogle Scholar
  16. 16.
    Peles S, Fisher NM, Devine SM, Tomasson MH, DiPersio JF, Vij R. Bortezomib (Velcade) when given pretransplant and once weekly as consolidation therapy following high dose chemotherapy (HDCT) leads to high rates of reactivation of Varicella Zoster Virus (VZV). ASH Annual Meeting Abstracts. 2005;106:3237–905a.Google Scholar
  17. 17.
    Schiller GJ, Sohn JP, Malone R, et al. Phase I/II Trial of Bortezomib maintenance following autologous peripheral blood progenitor cell transplantation as treatment for intermediate- and advanced-stage multiple myeloma. ASH Annual Meeting Abstracts. 2006;108:5433–453b.Google Scholar
  18. 18.
    Knop S, Hebart H, Kunzmann V, Angermund R, Einsele H. Bortezomib once weekly is well tolerated as maintenance therapy after less than a complete response to high-dose melphalan in patients with multiple myeloma. ASH Annual Meeting Abstracts. 2006;108:5099–364b.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Jonathan L. Kaufman
    • 1
  • Ronald Mihelic
  • Sagar Lonial
    • 1
  1. 1.Winship Cancer InstituteEmory University School of MedicineAtlantaUSA

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