Management of multiple myeloma: a systematic review and critical appraisal of published studies

Kumar, Amit; Loughran, Thomas P.; Alsina, Melissa; Durie, Brian G.M.; Djulbegoviĉ, Benjamin

doi:10.1016/s1470-2045(03)01077-5

Cited by 101 publications

(67 citation statements)

References 72 publications

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“…For EP, significantly better local control was reported for doses >45 Gy (100% 5-year LCR vs. 55% for <45 Gy) [15]. Considering the low treatment toxicity, doses of 40-50 Gy seem to be a general consensus for SBP [1,12,16] and of 40-60…”

Section: Influence Of Dosementioning

confidence: 97%

Radiotherapy of solitary plasmacytoma

et al. 2011

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International audienceSolitary plasmacytoma of the bone (SBP) or extramedullary plasmacytoma (EP) are rare neoplasms amenable to local radiotherapy. In this retrospective analysis, we report the University Heidelberg experience in the treatment of solitary plasmacytoma. From 1995 to 2008, 18 patients were treated with local radiotherapy. Ten patients suffered from SBP, eight patients showed a single extramedullary lesion. Local radiotherapy with a median dose of 45 Gy yielded excellent local control with only one patient suffering from local relapse. SBP and EP had significantly different 5-year multiple myeloma-free survival rates of 36.8% and 86.7%, respectively. However, no significant difference in overall survival could be detected. Radiotherapy can achieve excellent local control of solitary plasmacytoma. Progression to multiple myeloma, especially in the case of SBP, remains to be addressed by further studies

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Section: Influence Of Dosementioning

confidence: 97%

Radiotherapy of solitary plasmacytoma

et al. 2011

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“…Other reviews have also reported increased morbidity without convincing proof of improved survival. 114,135 However, there are intriguing data from the SWOG randomized trial of autologous transplant versus conventional chemotherapy. 107 The original trial had an ablative, allogeneic transplant group consisting of patients with HLA identical siblings; 36 received allografts, and due to the high 6-month mortality of 45%, the allogeneic arm was closed.…”

Section: Allogeneic Sctmentioning

confidence: 99%

Multiple Myeloma, Version 3.2017, NCCN Clinical Practice Guidelines in Oncology

Kumar¹,

Callander²,

Alsina³

et al. 2017

J Natl Compr Canc Netw

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174

127

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“…ASCT improves median OS in multiple myeloma by approximately 12 months [85][86][87][88]. However, three randomized trials show that OS is similar whether ASCT is done early (immediately following four cycles of induction therapy) or delayed (at the time of relapse as salvage therapy) [89][90][91].…”

Section: Role Of Hematopoietic Stem Cell Transplantationmentioning

confidence: 99%

Multiple myeloma: 2013 update on diagnosis, risk‐stratification, and management

2013

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Disease overviewMultiple myeloma accounts for approximately 10% of hematologic malignancies.DiagnosisThe diagnosis requires 10% or more clonal plasma cells on bone marrow examination or a biopsy proven plasmacytoma plus evidence of associated end‐organ damage. In addition, the presence of 60% or more clonal plasma cells in the marrow is also considered as myeloma regardless of the presence or absence of end‐organ damage.Risk stratificationIn the absence of concurrent trisomies, patients with 17p deletion, t(14;16), and t(14;20) are considered to have high‐risk myeloma. Patients with t(4;14) translocation are considered intermediate‐risk. All others are considered as standard‐risk.Risk‐adapted initial therapyStandard‐risk patients can be treated with lenalidomide plus low‐dose dexamethasone (Rd), or a bortezomib‐containing triplet such as bortezomib, cyclophosphamide, dexamethasone (VCD). Intermediate‐risk and high‐risk patients require a bortezomib‐based triplet regimen. In eligible patients, initial therapy is given for approximately 4 months followed by autologous stem cell transplantation (ASCT). Standard‐risk patients can opt for delayed ASCT if stem cells can be cryopreserved. In patients are not candidates for transplant, initial therapy is given for approximately 12–18 months.Maintenance therapyAfter initial therapy, lenalidomide maintenance is considered for standard‐risk patients who are not in very good partial response or better, while maintenance with a bortezomib‐based regimen should be considered in pateints with intermediate or high‐risk myeloma.Management of refractory diseasePatients with indolent relapse can be treated first with two‐drug or three‐drug combinations. Patients with more aggressive relapse often require therapy with a combination of multiple active agents. Am. J. Hematol. 88:225–235, 2013. © 2013 Wiley Periodicals, Inc.

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Management of multiple myeloma: a systematic review and critical appraisal of published studies

Cited by 101 publications

References 72 publications

Radiotherapy of solitary plasmacytoma

Radiotherapy of solitary plasmacytoma

Multiple Myeloma, Version 3.2017, NCCN Clinical Practice Guidelines in Oncology

Multiple myeloma: 2013 update on diagnosis, risk‐stratification, and management

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