Multiple myeloma accounts for approximately 10% of hematologic malignancies. Bortezomib plus melphalan and prednisone for initial treatment of multiple myeloma. Chimeric antigen receptor t cells against cd19 for multiple. Patients may present with bone pain or with symptoms that are often nonspecific, such as nausea. Among patients with newly diagnosed multiple myeloma who were ineligible for autologous stemcell. In heavily pretreated patients with relapsed or relapsed and refractory multiple myeloma, singleagent daratumumab was associated with an overall response rate of 31% and a median overall survival.
Lenalidomide plus dexamethasone is a reference treatment for relapsed multiple myeloma. We conducted a randomized trial of the treatment of multiple myeloma with high dose chemotherapy followed by either one or two successive autologous stem cell. Pdf carfilzomib, lenalidomide, and dexamethasone for. Abstract background lenalidomide plus dexamethasone is a standard treatment for patients with newly diagnosed multiple myeloma who are. Two and 3drug treatment regimens and autologous stem cell transplants provide opportunities for longer term disease remission, though most patients will still develop relapsed multiple myeloma. Multiple myeloma is a neoplastic plasmacell disorder that is characterized by clonal proliferation of malignant plasma cells in the bone marrow microenvironment, monoclonal protein in the blood or. Targeting cd38 with daratumumab monotherapy in multiple myeloma. Single versus double autologous stemcell transplantation. Daratumumab plus lenalidomide and dexamethasone versus lenalidomide and dexamethasone in relapsed or refractory multiple myeloma. First described in 1848, mm is characterized by a proliferation of malignant plasma cells and a subsequent overabundance of monoclonal paraprotein m protein. 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. In germany there are around 6500 new cases of multiple myeloma each year and it is the third most commonly occurring disease of the blood after leukemia and nonhodgkin lymphoma. A patient with refractory multiple myeloma received an infusion of ctl019 cells, a cellular therapy consisting of autologous t cells transduced.
Bortezomib plus melphalan and prednisone for initial treatment of. Multiple myeloma mm is a debilitating malignancy that is part of a spectrum of diseases ranging from monoclonal gammopathy of unknown significance mgus to plasma cell leukemia. Multiple myeloma accounts for around 1% of all cancers worldwide and 1015% of all hematological neoplasms. Crab hypercalcemia, renal failure, anemia, or lytic bone lesions features felt related to the plasma cell disorder, bone marrow clonal. Up to 50% of newly diagnosed patients have a decrease in creatine clearance and.
In this phase 3 trial, we randomly assigned 498 patients with relapsed or relapsed and refractory multiple myeloma to receive bortezomib 1. In patients with relapsed multiple myeloma, the addition of carfilzomib to lenalido mide and dexamethasone resulted in significantly improved. The imfs reach extends to more than 525,000 members in 140 countries worldwide. The average risk of progression to multiple myeloma is around 1% per annum 3, 4. Carfilzomib, lenalidomide, and dexamethasone for relapsed. Elotuzumab plus pomalidomide and dexamethasone for multiple. Longterm followup of monoclonal gammopathy of undetermined. We conducted a randomized trial of the treatment of multiple myeloma with highdose chemotherapy followed by either one or two successive autologous stemcell. In most patients multiple myeloma develops on the basis of monoclonal gammopathy of uncertain significance, which is diagnosed, usually incidentally, in 35% of persons over the age of 50 years. Monoclonal antibodies in multiple myeloma come of age nejm. Multiple myeloma is a malignancy of terminally differentiated plasma cells, and patients typically present with bone marrow infiltration of clonal plasma cells.
Esmo clinical practice guidelines for diagnosis, treatment and followup external link opens in a new window moreau p, san miguel j, sonneveld p, et al. Multiple myeloma and renal failure nephrology dialysis. We hope that the information will be helpful to both healthcare professionals and patients. Multiple myeloma mm is a clonal bcell disease of slowly proliferating plasma cells, accompanied by monoclonal protein production and lytic bone lesions. Daratumumab, bortezomib, and dexamethasone for multiple. Patients with multiple myeloma that was refractory or relapsed and refractory to lenalidomide and a proteasome inhibitor were randomly. Bortezomib works in the ubiquitinproteasome pathway of cellular protein homeostasis by blocking the action of the 26s proteasome, a. The imf is dedicated to improving the quality of life of myeloma patients while working toward prevention and a cure through.
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