International Myeloma Working Group Consensus Statement for the Management, Treatment, and Supportive Care of Patients With Myeloma Not Eligible for Standard Autologous Stem-Cell Transplantation

被引：293

作者：

Palumbo, Antonio ^{[1
]}

Rajkumar, S. Vincent ^{[3
]}

San Miguel, Jesus F. ^{[4
]}

Larocca, Alessandra ^{[1
]}

Niesvizky, Ruben ^{[5
]}

Morgan, Gareth ^{[6
]}

Landgren, Ola ^{[7
]}

Hajek, Roman ^{[8
,9
]}

Einsele, Hermann ^{[10
]}

Anderson, Kenneth C. ^{[11
]}

Dimopoulos, Meletios A. ^{[12
]}

Richardson, Paul G. ^{[11
]}

Cavo, Michele ^{[2
]}

Spencer, Andrew ^{[13
]}

Stewart, A. Keith ^{[14
]}

Shimizu, Kazuyuki ^{[15
]}

Lonial, Sagar ^{[16
]}

Sonneveld, Pieter ^{[17
]}

Durie, Brian G. M. ^{[18
]}

Moreau, Philippe ^{[19
]}

Orlowski, Robert Z. ^{[20
]}

机构：

[1] Univ Turin, I-10126 Turin, Italy

[2] Univ Bologna, Sch Med, Seragnoli Inst Hematol, Bologna, Italy

[3] Mayo Clin, Rochester, MN USA

[4] Univ Hosp Salamanca, Salamanca, Spain

[5] Weill Cornell Med Coll, New York, NY USA

[6] Royal Marsden Hosp, London SW3 6JJ, England

[7] NCI, Bethesda, MD 20892 USA

[8] Univ Ostrava, Sch Med, CZ-70103 Ostrava, Czech Republic

[9] Univ Hosp Ostrava, Ostrava, Czech Republic

[10] Univ Wurzburg, D-97070 Wurzburg, Germany

[11] Dana Farber Canc Inst, Boston, MA 02115 USA

[12] Univ Athens, Sch Med, GR-11527 Athens, Greece

[13] Alfred Hosp, Melbourne, Vic, Australia

[14] Mayo Clin, Scottsdale, AZ USA

[15] Aichi Gakuin Hosp, Nagoya, Aichi, Japan

[16] Emory Univ, Atlanta, GA 30322 USA

[17] Erasmus MC, Rotterdam, Netherlands

[18] Cedars Sinai Comprehens Canc Ctr, Los Angeles, CA USA

[19] Univ Hosp, Nantes, France

[20] Univ Texas Houston, MD Anderson Canc Ctr, Houston, TX 77030 USA

来源：

JOURNAL OF CLINICAL ONCOLOGY | 2014年 / 32卷 / 06期

关键词：

DIAGNOSED MULTIPLE-MYELOMA; LENALIDOMIDE PLUS DEXAMETHASONE; BORTEZOMIB-MELPHALAN-PREDNISONE; NEUROPATHIC CANCER PAIN; ELDERLY-PATIENTS; PERIPHERAL NEUROPATHY; ZOLEDRONIC ACID; PHASE-III; UNDETERMINED SIGNIFICANCE; MONOCLONAL GAMMOPATHY;

D O I：

10.1200/JCO.2013.48.7934

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose To provide an update on recent advances in the management of patients with multiple myeloma who are not eligible for autologous stem-cell transplantation. Methods A comprehensive review of the literature on diagnostic criteria is provided, and treatment options and management of adverse events are summarized. Results Patients with symptomatic disease and organ damage (ie, hypercalcemia, renal failure, anemia, or bone lesions) require immediate treatment. The International Staging System and chromosomal abnormalities identify high- and standard-risk patients. Proteasome inhibitors, immunomodulatory drugs, corticosteroids, and alkylating agents are the most active agents. The presence of concomitant diseases, frailty, or disability should be assessed and, if present, treated with reduced-dose approaches. Bone disease, renal damage, hematologic toxicities, infections, thromboembolism, and peripheral neuropathy are the most frequent disabling events requiring prompt and active supportive care. Conclusion These recommendations will help clinicians ensure the most appropriate care for patients with myeloma in everyday clinical practice. (C) 2014 by American Society of Clinical Oncology

引用

页码：587 / +

页数：17

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