Management of high-risk Myeloma: an evidence-based review of treatment strategies
| Autor: | Hartmut Goldschmidt, Nicola Lehners, Patrick Hayden, Marc S. Raab |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment MEDLINE Disease Hematopoietic stem cell transplantation Risk Assessment Transplantation Autologous 03 medical and health sciences 0302 clinical medicine Maintenance therapy Recurrence Risk Factors Antineoplastic Combined Chemotherapy Protocols medicine Animals Humans Transplantation Homologous Autologous transplantation Genetic Predisposition to Disease Intensive care medicine Multiple myeloma Evidence-Based Medicine business.industry Standard treatment Hematopoietic Stem Cell Transplantation Disease Management Hematology Evidence-based medicine medicine.disease Combined Modality Therapy Drug Resistance Neoplasm 030220 oncology & carcinogenesis Immunology Multiple Myeloma business Algorithms 030215 immunology |
| Zdroj: | Expert Review of Hematology. 9:753-765 |
| ISSN: | 1747-4094 1747-4086 |
| Popis: | Despite the progress made in the treatment of patients with multiple myeloma over recent decades, a significant cohort with high-risk disease as defined by specific clinical and genetic criteria continue to respond poorly to standard treatment. These patients represent a particular challenge to the treating physician and require early identification as well as personalized treatment strategies.In this review, we discuss the prognostic impact of adverse clinical, radiological and genetic factors, evaluate available scoring systems and highlight key aspects of the therapeutic management of high-risk myeloma. MEDLINE and recent scientific meetings' databases were searched for the keywords 'high-risk' and 'multiple myeloma' and relevant studies relating to both diagnostic and therapeutic approaches were identified. Expert commentary: A case is made for intensive induction using combinations of novel agents, early high-dose therapy supported by autologous stem cell transplantation and the widespread use of maintenance therapies. Novel therapeutic options, especially in the field of immunotherapy, are currently explored in clinical trials and have the potential to further improve outcomes for patients with high-risk multiple myeloma. |
| Databáze: | OpenAIRE |
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