Treatment of newly diagnosed myeloma

A. Palumbo, S Vincent Rajkumar

Research output: Contribution to journalArticle

74 Citations (Scopus)

Abstract

The introduction of thalidomide, bortezomib and lenalidomide has dramatically changed the treatment paradigm of multiple myeloma (MM). In patients eligible for autologous stem cell transplant (ASCT), combinations including thalidomide/dexamethasone (Thal/Dex) or bortezomib/dexamethasone (Bort/Dex) or lenalidomide/dexamethasone (Rev/Dex) have been introduced as induction regimens in patients eligible for ASCT. New induction regimens have significantly increased complete response rate before and after ASCT with a positive impact on progression-free survival. Maintenance therapy with thalidomide, under investigation with lenalidomide, may further prolong remission duration. In patients not eligible for ASCT, randomized studies have shown that melphalan, prednisone, thalidomide (MPT) and melphalan, prednisone and bortezomib (MPV) are both superior to melphalan and prednisone (MP), and are now considered standard of care. Ongoing trials will soon assess if MP plus lenalidomide may be considered an attractive option. More complex regimens combining thalidomide or bortezomib or lenalidomide with cyclophosphamide or doxorubicin have been also tested. In small cohorts of patients bortezomib or lenalidomide may overcome the poor prognosis induced by deletion 13 or translocation t(4;14) or deletion 17p13. If these data will be confirmed, a cytogenetically risk-adapted strategy might become the most appropriate strategy.

Original languageEnglish (US)
Pages (from-to)449-456
Number of pages8
JournalLeukemia
Volume23
Issue number3
DOIs
StatePublished - 2009

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Thalidomide
Melphalan
Prednisone
Stem Cells
Dexamethasone
Transplants
Therapeutics
Standard of Care
Multiple Myeloma
Doxorubicin
Cyclophosphamide
Disease-Free Survival
lenalidomide
Bortezomib

ASJC Scopus subject areas

  • Hematology
  • Cancer Research
  • Anesthesiology and Pain Medicine

Cite this

Treatment of newly diagnosed myeloma. / Palumbo, A.; Rajkumar, S Vincent.

In: Leukemia, Vol. 23, No. 3, 2009, p. 449-456.

Research output: Contribution to journalArticle

Palumbo, A. ; Rajkumar, S Vincent. / Treatment of newly diagnosed myeloma. In: Leukemia. 2009 ; Vol. 23, No. 3. pp. 449-456.
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