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

共 123 条

[21] Bortezomib with thalidomide plus dexamethasone compared with thalidomide plus dexamethasone as induction therapy before, and consolidation therapy after, double autologous stem-cell transplantation in newly diagnosed multiple myeloma: a randomised phase 3 study [J].

Cavo, Michele ;

Tacchetti, Paola ;

Patriarca, Francesca ;

Petrucci, Maria Teresa ;

Pantani, Lucia ;

Galli, Monica ;

Di Raimondo, Francesco ;

Crippa, Claudia ;

Zamagni, Elena ;

Palumbo, Antonio ;

Offidani, Massimo ;

Corradini, Paolo ;

Narni, Franco ;

Spadano, Antonio ;

Pescosta, Norbert ;

Deliliers, Giorgio Lambertenghi ;

Ledda, Antonio ;

Cellini, Claudia ;

Caravita, Tommaso ;

Tosi, Patrizia ;

Baccarani, Michele .

LANCET, 2010, 376 (9758) :2075-2085

[22] Deletion of chromosome 13 detected by conventional cytogenetics is a critical prognostic factor in myeloma [J].

Chiecchio, L. ;

Protheroe, R. K. M. ;

Ibrahim, A. H. ;

Cheung, K. L. ;

Rudduck, C. ;

Dagrada, G. P. ;

Cabanas, E. D. ;

Parker, T. ;

Nightingale, M. ;

Wechalekar, A. ;

Orchard, K. H. ;

Harrison, C. J. ;

Cross, N. C. P. ;

Morgan, G. J. ;

Ross, F. M. .

LEUKEMIA, 2006, 20 (09) :1610-1617

[23] IMWG consensus on risk stratification in multiple myeloma [J].

Chng, W. J. ;

Dispenzieri, A. ;

Chim, C-S ;

Fonseca, R. ;

Goldschmidt, H. ;

Lentzsch, S. ;

Munshi, N. ;

Palumbo, A. ;

Miguel, J. S. ;

Sonneveld, P. ;

Cavo, M. ;

Usmani, S. ;

Durie, B. G. M. ;

Avet-Loiseau, H. .

LEUKEMIA, 2014, 28 (02) :269-277

[24] Understanding the role of hyperdiploidy in myeloma prognosis: which trisomies really matter? [J].

Chretien, Marie-Lorraine ;

Corre, Jill ;

Lauwers-Cances, Valerie ;

Magrangeas, Florence ;

Cleynen, Alice ;

Yon, Edwige ;

Hulin, Cyrille ;

Leleu, Xavier ;

Orsini-Piocelle, Frederique ;

Blade, Jean-Sebastien ;

Sohn, Claudine ;

Karlin, Lionel ;

Delbrel, Xavier ;

Hebraud, Benjamin ;

Roussel, Murielle ;

Marit, Gerald ;

Garderet, Laurent ;

Mohty, Mohamad ;

Rodon, Philippe ;

Voillat, Laurent ;

Royer, Bruno ;

Jaccard, Arnaud ;

Belhadj, Karim ;

Fontan, Jean ;

Caillot, Denis ;

Stoppa, Anne-Marie ;

Attal, Michel ;

Facon, Thierry ;

Moreau, Philippe ;

Minvielle, Stephane ;

Avet-Loiseau, Herve .

BLOOD, 2015, 126 (25) :2713-2719

[25] CS1-specific chimeric antigen receptor (CAR)-engineered natural killer cells enhance in vitro and in vivo antitumor activity against human multiple myeloma [J].

Chu, J. ;

Deng, Y. ;

Benson, D. M. ;

He, S. ;

Hughes, T. ;

Zhang, J. ;

Peng, Y. ;

Mao, H. ;

Yi, L. ;

Ghoshal, K. ;

He, X. ;

Devine, S. M. ;

Zhang, X. ;

Caligiuri, M. A. ;

Hofmeister, C. C. ;

Yu, J. .

LEUKEMIA, 2014, 28 (04) :917-927

[26] Genetic Modification of T Cells Redirected toward CS1 Enhances Eradication of Myeloma Cells [J].

Chu, Jianhong ;

He, Shun ;

Deng, Youcai ;

Zhang, Jianying ;

Peng, Yong ;

Hughes, Tiffany ;

Yi, Ling ;

Kwon, Chang-Hyuk ;

Wang, Qi-En ;

Devine, Steven M. ;

He, Xiaoming ;

Bai, Xue-Feng ;

Hofmeister, Craig C. ;

Yu, Jianhua .

CLINICAL CANCER RESEARCH, 2014, 20 (15) :3989-4000

[27] Prognostic factors for donor lymphocyte infusions following non-myeloablative allogeneic stem cell transplantation in multiple myeloma [J].

de Donk, N. W. C. J. van ;

Kroeger, N. ;

Hegenbart, U. ;

Corradini, P. ;

Miguel, J. F. San ;

Goldschmidt, H. ;

Perez-Simon, J. A. ;

Zijlmans, M. ;

Raymakers, R. A. ;

Montefusco, V. ;

Ayuk, F. A. ;

van Oers, M. H. J. ;

Nagler, A. ;

Verdonck, L. F. ;

Lokhorst, H. M. .

BONE MARROW TRANSPLANTATION, 2006, 37 (12) :1135-1141

[28] Prediction of survival in multiple myeloma based on gene expression profiles reveals cell cycle and chromosomal instability signatures in high-risk patients and hyperdiploid signatures in low-risk patients:: A study of the intergroupe francophone du myelome [J].

Decaux, Olivier ;

Lode, Laurence ;

Magrangeas, Florence ;

Charbonnel, Catherine ;

Gouraud, Wilfried ;

Jezequel, Pascal ;

Attal, Michel ;

Harousseau, Jean-Luc ;

Moreau, Philippe ;

Bataille, Regis ;

Campion, Loic ;

Avert-Loiseau, Herve ;

Minvielle, Stephane .

JOURNAL OF CLINICAL ONCOLOGY, 2008, 26 (29) :4798-4805

[29] Significant improvement in the survival of patients with multiple myeloma presenting with severe renal impairment after the introduction of novel agents [J].

Dimopoulos, M. A. ;

Delimpasi, S. ;

Katodritou, E. ;

Vassou, A. ;

Kyrtsonis, M. C. ;

Repousis, P. ;

Kartasis, Z. ;

Parcharidou, A. ;

Michael, M. ;

Michalis, E. ;

Gika, D. ;

Symeonidis, A. ;

Pouli, A. ;

Konstantopoulos, K. ;

Terpos, E. ;

Kastritis, E. .

ANNALS OF ONCOLOGY, 2014, 25 (01) :195-200

[30] HIGH SERUM LACTATE-DEHYDROGENASE LEVEL AS A MARKER FOR DRUG-RESISTANCE AND SHORT SURVIVAL IN MULTIPLE-MYELOMA [J].

DIMOPOULOS, MA ;

BARLOGIE, B ;

SMITH, TL ;

ALEXANIAN, R .

ANNALS OF INTERNAL MEDICINE, 1991, 115 (12) :931-935

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