RT Journal Article
T1 Treatment options for relapse after autograft in multiple myeloma - report from an EBMT educational meeting.
A1 Garderet, Laurent
A1 Cook, Gordon
A1 Auner, Holger W
A1 Bruno, Benedetto
A1 Lokhorst, Henk
A1 Perez-Simon, Jose Antonio
A1 Sahebi, Firoozeh
A1 Scheid, Christof
A1 Morris, Curly
A1 van Biezen, Anja
A1 Sobh, Mohamad
A1 Michallet, Mauricette
A1 Gahrton, Gösta
A1 Schönland, Stefan
A1 Kröger, Nicolaus
K1 Myeloma
K1 allogeneic stem cell transplantation
K1 autologous stem cell transplantation
K1 immunomodulatory drugs
K1 monoclonal antibodies
K1 proteasome inhibitors
K1 relapse
AB Major improvements have been made in the treatment of myeloma. However, all patients, perhaps with some exceptions, eventually relapse, even after autologous stem cell transplantation (ASCT). In that setting, the combinations of new drugs, namely the IMiDs and the proteasome inhibitors along with steroids, give encouraging results in relapsed patients. The median progression-free survival (PFS) is 20 months with lenalidomide plus dexamethasone plus ixazomib and 26 months with lenalidomide plus dexamethasone plus carfilzomib. Monoclonal antibodies have emerged as an additional new treatment option. The antibody anti-SLAMF7, elotuzumab, in combination with lenalidomide plus dexamethasone gives a median PFS of 20 months. The antibody daratumumab, targeting CD38, alone has an outstanding activity in previously heavily treated patients. Its use in combination is ongoing. Transplantation remains a major treatment option. For patients who relapse at least 18 months from the initial ASCT, a second ASCT can be performed with an expected time to progression of 19 months from the time of transplantation. For patients relapsing earlier and/or with high-risk characteristics and who are still chemosensitive, with a suitable donor, an allogeneic transplantation can be considered. The optimal treatment combination and sequence remain to be determined.
YR 2016
FD 2016-09-21
LK http://hdl.handle.net/10668/10465
UL http://hdl.handle.net/10668/10465
LA en
DS RISalud
RD Apr 5, 2025