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International Myeloma Working Group consensus statement for the management, treatment, and supportive care of patients with myeloma not eligible for standard autologous stem-cell transplantation.

TitleInternational Myeloma Working Group consensus statement for the management, treatment, and supportive care of patients with myeloma not eligible for standard autologous stem-cell transplantation.
Publication TypeJournal Article
Year of Publication2014
AuthorsPalumbo A, S Rajkumar V, San Miguel JF, Larocca A, Niesvizky R, Morgan G, Landgren O, Hajek R, Einsele H, Anderson KC, Dimopoulos MA, Richardson PG, Cavo M, Spencer A, A Stewart K, Shimizu K, Lonial S, Sonneveld P, Durie BGM, Moreau P, Orlowski RZ
JournalJ Clin Oncol
Volume32
Issue6
Pagination587-600
Date Published2014 Feb 20
ISSN1527-7755
KeywordsHematopoietic Stem Cell Transplantation, Humans, Multiple Myeloma, Palliative Care, Prognosis
Abstract

PURPOSE: To provide an update on recent advances in the management of patients with multiple myeloma who are not eligible for autologous stem-cell transplantation.

METHODS: A comprehensive review of the literature on diagnostic criteria is provided, and treatment options and management of adverse events are summarized.

RESULTS: Patients with symptomatic disease and organ damage (ie, hypercalcemia, renal failure, anemia, or bone lesions) require immediate treatment. The International Staging System and chromosomal abnormalities identify high- and standard-risk patients. Proteasome inhibitors, immunomodulatory drugs, corticosteroids, and alkylating agents are the most active agents. The presence of concomitant diseases, frailty, or disability should be assessed and, if present, treated with reduced-dose approaches. Bone disease, renal damage, hematologic toxicities, infections, thromboembolism, and peripheral neuropathy are the most frequent disabling events requiring prompt and active supportive care.

CONCLUSION: These recommendations will help clinicians ensure the most appropriate care for patients with myeloma in everyday clinical practice.

DOI10.1200/JCO.2013.48.7934
Alternate JournalJ. Clin. Oncol.
PubMed ID24419113
PubMed Central IDPMC3918540
Grant ListP50 CA142509 / CA / NCI NIH HHS / United States
U10 CA032102 / CA / NCI NIH HHS / United States