Management of high-risk Myeloma: an evidence-based review of treatment strategies

被引：1

作者：

Lehners, Nicola ^{[1
]}

Hayden, Patrick J. ^{[2
]}

Goldschmidt, Hartmut ^{[1
]}

Raab, Marc-Steffen ^{[1
]}

机构：

[1] Univ Heidelberg Hosp, Dept Hematol, Neuenheimer Feld 410, D-69120 Heidelberg, Germany

[2] Trinity Coll Dublin, Acad Dept Haematol, St Jamess Hosp, Dublin 2, Ireland

来源：

EXPERT REVIEW OF HEMATOLOGY | 2016年 / 9卷 / 08期

关键词：

Multiple myeloma; high-risk myeloma; risk factors; autologous transplantation; allogeneic transplantation; maintenance therapy; novel agents; STEM-CELL TRANSPLANTATION; DIAGNOSED MULTIPLE-MYELOMA; INTERNATIONAL STAGING SYSTEM; MINIMAL RESIDUAL DISEASE; BORTEZOMIB PLUS DEXAMETHASONE; MULTIPARAMETER FLOW-CYTOMETRY; SINGLE-CENTER EXPERIENCE; TOTAL THERAPY 3; WORKING GROUP; LENALIDOMIDE MAINTENANCE;

D O I：

10.1080/17474086.2016.1204908

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Introduction: Despite the progress made in the treatment of patients with multiple myeloma over recent decades, a significant cohort with high-risk disease as defined by specific clinical and genetic criteria continue to respond poorly to standard treatment. These patients represent a particular challenge to the treating physician and require early identification as well as personalized treatment strategies.Areas covered: In this review, we discuss the prognostic impact of adverse clinical, radiological and genetic factors, evaluate available scoring systems and highlight key aspects of the therapeutic management of high-risk myeloma. MEDLINE and recent scientific meetings' databases were searched for the keywords high-risk' and multiple myeloma' and relevant studies relating to both diagnostic and therapeutic approaches were identified.Expert commentary: A case is made for intensive induction using combinations of novel agents, early high-dose therapy supported by autologous stem cell transplantation and the widespread use of maintenance therapies. Novel therapeutic options, especially in the field of immunotherapy, are currently explored in clinical trials and have the potential to further improve outcomes for patients with high-risk multiple myeloma.

引用

页码：753 / 765

页数：13

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