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

Antonio Palumbo, S Vincent Rajkumar, Jesus F. San Miguel, Alessandra Larocca, Ruben Niesvizky, Gareth Morgan, Ola Landgren, Roman Hajek, Hermann Einsele, Kenneth C. Anderson, Meletios A. Dimopoulos, Paul G. Richardson, Michele Cavo, Andrew Spencer, Alexander Keith Stewart, Kazuyuki Shimizu, Sagar Lonial, Pieter Sonneveld, Brian G M Durie, Philippe MoreauRobert Z. Orlowski

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)587-600
Number of pages14
JournalJournal of Clinical Oncology
Volume32
Issue number6
DOIs
StatePublished - Feb 20 2014

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Stem Cell Transplantation
Patient Care
Proteasome Inhibitors
Alkylating Agents
Bone Diseases
Thromboembolism
Hypercalcemia
Peripheral Nervous System Diseases
Multiple Myeloma
Chromosome Aberrations
Renal Insufficiency
Anemia
Adrenal Cortex Hormones
Therapeutics
Kidney
Bone and Bones
Infection
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

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. / Palumbo, Antonio; Rajkumar, S Vincent; San Miguel, Jesus F.; Larocca, Alessandra; Niesvizky, Ruben; Morgan, Gareth; Landgren, Ola; Hajek, Roman; Einsele, Hermann; Anderson, Kenneth C.; Dimopoulos, Meletios A.; Richardson, Paul G.; Cavo, Michele; Spencer, Andrew; Stewart, Alexander Keith; Shimizu, Kazuyuki; Lonial, Sagar; Sonneveld, Pieter; Durie, Brian G M; Moreau, Philippe; Orlowski, Robert Z.

In: Journal of Clinical Oncology, Vol. 32, No. 6, 20.02.2014, p. 587-600.

Research output: Contribution to journalArticle

Palumbo, A, Rajkumar, SV, San Miguel, JF, Larocca, A, Niesvizky, R, Morgan, G, Landgren, O, Hajek, R, Einsele, H, Anderson, KC, Dimopoulos, MA, Richardson, PG, Cavo, M, Spencer, A, Stewart, AK, Shimizu, K, Lonial, S, Sonneveld, P, Durie, BGM, Moreau, P & Orlowski, RZ 2014, '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', Journal of Clinical Oncology, vol. 32, no. 6, pp. 587-600. https://doi.org/10.1200/JCO.2013.48.7934
Palumbo, Antonio ; Rajkumar, S Vincent ; San Miguel, Jesus F. ; Larocca, Alessandra ; Niesvizky, Ruben ; Morgan, Gareth ; Landgren, Ola ; Hajek, Roman ; Einsele, Hermann ; Anderson, Kenneth C. ; Dimopoulos, Meletios A. ; Richardson, Paul G. ; Cavo, Michele ; Spencer, Andrew ; Stewart, Alexander Keith ; Shimizu, Kazuyuki ; Lonial, Sagar ; Sonneveld, Pieter ; Durie, Brian G M ; Moreau, Philippe ; Orlowski, Robert Z. / 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. In: Journal of Clinical Oncology. 2014 ; Vol. 32, No. 6. pp. 587-600.
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T1 - 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

AU - Palumbo, Antonio

AU - Rajkumar, S Vincent

AU - San Miguel, Jesus F.

AU - Larocca, Alessandra

AU - Niesvizky, Ruben

AU - Morgan, Gareth

AU - Landgren, Ola

AU - Hajek, Roman

AU - Einsele, Hermann

AU - Anderson, Kenneth C.

AU - Dimopoulos, Meletios A.

AU - Richardson, Paul G.

AU - Cavo, Michele

AU - Spencer, Andrew

AU - Stewart, Alexander Keith

AU - Shimizu, Kazuyuki

AU - Lonial, Sagar

AU - Sonneveld, Pieter

AU - Durie, Brian G M

AU - Moreau, Philippe

AU - Orlowski, Robert Z.

PY - 2014/2/20

Y1 - 2014/2/20

N2 - 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.

AB - 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.

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