BJH - volume 9, issue Multiple Myeloma Special Edition, december 2018
M.C. Vekemans MD, N. Meuleman MD, PhD, C. Doyen MD, PhD, K.L. Wu MD, PhD, P. Mineur MD, G. Bries MD, PhD, A. Kentos MD, L. Michaux MD, PhD, M. Delforge MD, PhD
With the introduction of immunomodulatory agents (IMiDs) and proteasome inhibitors (PIs), major improvements have been achieved in the treatment and outcome of multiple myeloma (MM). Different treatment combinations are now in use and newer therapies are being developed. Nevertheless, autologous stem cell transplantation (ASCT) remains the corner stone of therapy for fit, newly-diagnosed MM patients. Based on an extensive review of the recent literature, we propose recommendations on myeloma care, to be used by haematologists as a reference for daily practice.
Read moreBJH - volume 9, issue Multiple Myeloma Special Edition, december 2018
C. Doyen MD, PhD, M.C. Vekemans MD
Multiple Myeloma (MM) is mainly a disease of the elderly. In 2018 bortezomib-melphalan-prednisone (VMP) and lenalidomide-dexamethasone (Rd) are the established standard of care first-line regimens. Before starting therapy, an accurate evaluation of the frailty of patients is needed which allows physicians to individualize the approach for the individual patient.
Read moreBJH - volume 9, issue Multiple Myeloma Special Edition, december 2018
M. Delforge MD, PhD
For the majority of multiple myeloma (MM) patients, their disease will behave as a chronic disorder with episodes of remission followed by disease progression. Whereas the treatment approach in frontline is rather uniform, treatment at relapse has become more heterogeneous, as therapeutic choices at this stage are driven by many factors including disease characteristics and patient status, but also the previous treatment(s), their therapeutic effect and toxicities, and drug availability. With each treatment course patients also tend to become more vulnerable to hematological and non-hematological toxicities. Therefore, particularly at later relapses where there is no standard of care, the benefits and potential risks of therapeutic decisions should be carefully balanced in each individual patient, to minimize excess toxicities. In this review article, an overview is provided of the currently available treatment options for patients with relapsed or refractory MM.
Read moreBJH - volume 9, issue Multiple Myeloma Special Edition, december 2018
A. Van de Velde MD, M. Timmers , P. Vlummens MD, S. Anguille MD, PhD
New therapeutic antibodies and T cells redirected to specific antigen targets with engineered chimeric antigen receptors (CARs) are emerging as powerful therapies in haematologic malignancies and multiple myeloma (MM). Various designs, manufacturing processes, and study populations, among other variables, have been tested and reported in clinical trials in MM. Here, we review and compare ongoing trials and the results of the reported clinical trials. We also discuss the outlook for CAR-T cell therapies, including managing toxicities and expanding the availability of personalized cell therapy as a promising approach to all haematologic malignancies.
Read moreBJH - volume 9, issue Multiple Myeloma Special Edition, december 2018
M. Vercruyssen , N. Meuleman MD, PhD
Patients with multiple myeloma (MM) not only require treatments directed at their disease activity, but also need a wide range of supportive measures. In this review article supportive measures with respect to anaemia, infections, thromboembolic risk, bone disease, peripheral neuropathy and pain are discussed.
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