Multiple myeloma

Shaji K. Kumar, Vincent Rajkumar, Robert A. Kyle, Mark Van Duin, Pieter Sonneveld, María Victoria Mateos, Francesca Gay, Kenneth C. Anderson

Research output: Contribution to journalArticlepeer-review

334 Scopus citations

Abstract

Multiple myeloma is a malignancy of terminally differentiated plasma cells, and patients typically present with bone marrow infiltration of clonal plasma cells and monoclonal protein in the serum and/or urine. The diagnosis of multiple myeloma is made when clear end-organ damage attributable to the plasma cell proliferative disorder or when findings that suggest a high likelihood of their development are present. Distinguishing symptomatic multiple myeloma that requires treatment from the precursor stages of monoclonal gammopathy of undetermined significance and smouldering multiple myeloma is important, as observation is the standard for those conditions. Much progress has been made over the past decade in the understanding of disease biology and individualized treatment approaches. Several new classes of drugs, such as proteasome inhibitors and immunomodulatory drugs, have joined the traditional armamentarium (corticosteroids, alkylating agents and anthracyclines) and, along with high-dose therapy and autologous haemopoietic stem cell transplantation, have led to deeper and durable clinical responses. Indeed, an increasing proportion of patients are achieving lasting remissions, raising the possibility of cure for this disease. Success will probably depend on using combinations of effective agents and treating patients in the early stages of disease, such as patients with smouldering multiple myeloma.

Original languageEnglish (US)
Article number17046
JournalNature Reviews Disease Primers
Volume3
DOIs
StatePublished - Jul 20 2017

ASJC Scopus subject areas

  • General Medicine

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