Multiple myeloma mm is a neoplastic plasma cell disorder that results in endorgan damage hypercalcemia, renal insufficiency, anemia, or skeletal lesions. Daratumumab, bortezomib, and dexamethasone for multiple myeloma. Multiple myeloma mm is a cancer that occurs in plasma cells, which fall under the category of white blood cells that are in charge of antibody production. Multiple myeloma is a neoplasm of plasma cells characterised by the production of monoclonal immunoglobulin by the malignant cells. What is multiple myeloma definition, answers and support. Multiple myeloma in a young female presenting with.
Advancing against multiple myeloma center for cancer. Multiple myeloma mm is a plasma cell dyscrasia characterized by terminally differentiated plasma cells, infiltration of the bone marrow by plasma cells, and the presence of a monoclonal immunoglobulin or immunoglobulin fragment in the serum andor urine. Objective multiple myeloma can pose a diagnostic challenge and this article highlights issues in diagnosis and provides an overview of management. Raise awareness about education needs of healthcare providers in the community setting related to the management of multiple myeloma patients. Some early cancers may have signs and symptoms that can be noticed, but that is not always the case. Daratumumab, lenalidomide, and dexamethasone for multiple myeloma. Extramedullary plasmacytomas are discrete soft tissue masses of neoplastic monoclonal plasma cells that often. Multiple myeloma is associated with organ dysfunction, including bone lesions, anemia, renal insufficiency, and hypercalcemia. Purpose to provide evidencebased recommendations on the treatment of multiple myeloma to practicing physicians and others.
Up to 50% of newly diagnosed patients have a decrease in creatine clearance and. Multiple myeloma is a neoplastic plasmacell disorder that is characterized by clonal. Life with myeloma april 14, 2020 these days it can seem like all other medical problems take a back seat to covid19, but remember that cancer care is still a priority for most oncologi. Multiple myeloma develops when a normal plasma cell changes into a myeloma cell. American roentgen ray society images of multiple myeloma epidemiology and demographics all images xrays echo and ultrasound ct images mri. Minimal residual disease in multiple myeloma myeloma revealed. Smoldering multiple myeloma smm is an asymptomatic clonal plasma cell disorder. The international myeloma foundation medical and editorial content team. Whether you or a loved one are worried about developing multiple myeloma, have just been diagnosed, are going through treatment, or are trying to stay well after treatment, this detailed guide can help you find the answers you need.
Common manifestations include lytic lesions in bones causing pain, andor fractures, renal insufficiency, hypercalcemia, anemia, and recurrent infections. Pdf carfilzomib, lenalidomide, and dexamethasone for. Among other plasma cell dyscrasias, such as waldenstroms macroglobulinaemia and primary amyloidosis, multiple myeloma is the second most frequent haematological malignancy with an ageadjusted incidence of six per 100 000 per year in the usa and europe. In this discussion we will look at the destructive disease process which symbolises multiple myeloma with the aid of our full colour graphics. Risk factors for multiple myeloma american cancer society. Multiple myeloma epidemiology and demographics on the web most recent articles. Daratumumab, lenalidomide, and dexamethasone for multiple.
Targeting cd38 with daratumumab monotherapy in multiple myeloma. Multiple myeloma is a type of cancer that affects plasma cells. Abstract background lenalidomide plus dexamethasone is a standard treatment for patients with newly diagnosed multiple myeloma who are. In general risks of myeloma far overwhelm risks of a second cancer risks are highest when given with oral melphalan this risk is more concerning in a patient who has a very low risk of early death from myeloma. Aug 16, 2018 multiple myeloma accounts for 1% of all cancers and approximately 10% of all hematologic malignancies. Your myeloma survival rate will depend largely on how you respond to your induction therapy.
Multiple myeloma is a clonal plasma cell malignancy that accounts for slightly more than 10% of all hematologic cancers. Multiple myeloma occurs in both men and women, but more common in men and manifests from age 40 with a peak at 60 years. Multiple myeloma is the second most common type of blood cancer after leukemia. Read a 1page fact sheet that offers an introduction to multiple myeloma. The patient handbook focuses on the questions and decisions that a newly diagnosed patient faces. Those in the younger age group have been shown to have a more aggressive course but reportedly have had similar responses to treatment compared to older cohorts. This fact sheet is available as a pdf, so it is easy to print out. Patients with the disease require multiple treatments to try to slow the division but even with therapy, most of them eventually relapse, and only about half survive for five years after diagnosis. 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. Patients with multiple myeloma that was refractory or relapsed and refractory to lenalidomide and a proteasome inhibitor were randomly assigned to receive elotuzumab plus pomalidomide and dexamethasone elotuzumab group or pomalidomide and dexamethasone alone control group. Daratumumab plus lenalidomide and dexamethasone versus lenalidomide and dexamethasone in relapsed or refractory multiple myeloma.
It is almost invariably preceded by premalignant stages of monoclonal gammopathy of undetermined significance mgus and smoldering mm smm, although not all cases of mgus will eventually progress to mm. A population study to define the incidence and survival of multiple myeloma in a national health service region in uk. 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. My experience as both a mm survivor and mm coach is thatsurvival rates for multiple myeloma depend on your therapy.
First described in 1848, mm is characterized by a proliferation of malignant plasma cells and a subsequent overabundance of monoclonal paraprotein m protein. Incidence of hematologic malignancies in europe by morphologic subtype. Multiple myeloma accounts for 1% of all cancers and approximately 10% of all hematologic malignancies. 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. Aug 29, 2019 multiple myeloma patients who are refractory to the three major classes of targeted therapies proteasome inhibitors, immunomodulatory agents, and the anticd38 monoclonal antibody daratumumab have limited treatment options and poor survival. We conducted a randomized trial of the treatment of multiple myeloma with highdose. Daratumumab showed promising efficacy alone and with lenalidomide and dexamethasone in a phase 12 study involving patients with relapsed or refractory multiple myeloma. Background multiple myeloma is characterised by the proliferation of malignant plasma cells within the bone marrow, which produce an abnormal monoclonal paraprotein and evidence of end organ damage.
Plasma cells are a type of white blood cell found in bone marrow, which is the soft tissue inside most of your bones that produces. Multiple myeloma symptoms, diagnosis and treatment bmj. Multiple myeloma and renal failure nephrology dialysis. Jun 26, 20 multiple myeloma is the second most common 1015% of all haematological cancer. Elotuzumab plus pomalidomide and dexamethasone for. In multiple myeloma, white blood cells known as plasma cells divide uncontrollably in the bone marrow. Smm is distinguished from monoclonal gammopathy of undetermined significance by a much higher risk of progression to multiple myeloma mm.
Multiple myeloma epidemiology and demographics wikidoc. Multiple myeloma is a malignancy of terminally differentiated plasma cells, and patients typically present with bone marrow infiltration of clonal plasma cells. Elotuzumab plus pomalidomide and dexamethasone for multiple. It will help you learn medical terms and concepts you may not have encountered before. Educate the multidisciplinary healthcare team on how to implement effective practices in the treatment of multiple myeloma in communitybased programs. Daratumumab, bortezomib, and dexamethasone for multiple. Erythropoietin treatment of anemia associated with multiple myeloma.
There have been major advances in the diagnosis, prognosis, and management of smm in the last few years. Patients should not be treated unless they have symptomatic endorgan damage mm. Original article from the new england journal of medicine daratumumab, bortezomib, and dexamethasone for multiple myeloma. Phase 12 study of daratumumab, lenalidomide, and dexamethasone for relapsed multiple myeloma.
Multiple myeloma is a disease in which a neoplastic proliferation of plasma cells produces a monoclonal immunoglobulin. Among patients with newly diagnosed multiple myeloma who were ineligible for. Lahtinen r, laakso m, palva i, virkkunen p, elomaa i. Multiple myeloma is a cancer of plasma cells that has an estimated incidence of 26850 new patients in 2015 in the united states. The average risk of progression to multiple myeloma is around 1% per annum 3, 4. Plasma cells originate in the bone marrow and play an important role in the immune system. Carfilzomib, lenalidomide, and dexamethasone for relapsed multiple myeloma article pdf available in new england journal of medicine 3722 december 2014 with 833 reads how we measure reads. View a short video led by an asco expert and patient advocate that provides basic information and areas of research related to multiple myeloma. I have lived with multiple myeloma since my diagnosis in 1994. A patient with refractory multiple myeloma received an infusion of ctl019 cells, a cellular therapy consisting of autologous t cells transduced with an anticd19 chimeric antigen receptor, after myeloablative chemotherapy melphalan, 140 mg per square meter of bodysurface area and autologous stemcell transplantation. Multiple myeloma mm is a plasma cell dyscrasia characterised by terminally differentiated plasma cells, infiltration of the bone marrow by plasma cells, and the presence of a monoclonal immunoglobulin or immunoglobulin fragment in the serum andor urine.
Randomised, placebocontrolled multicentre trial of clodronate in multiple myeloma. Dec 22, 2014 multiple myeloma is a malignant disease characterised by proliferation of clonal plasma cells in the bone marrow and typically accompanied by the secretion of monoclonal immunoglobulins that are detectable in the serum or urine. Patients with multiple myeloma that was refractory or relapsed and refractory to lenalidomide and a proteasome inhibitor were randomly assigned. Someone who has a sibling or parent with myeloma is more likely to get it than someone who does not have this family history. Learn more about the symptoms, causes, diagnosis, risk factors, and treatment of multiple myeloma. May 14, 2015 smoldering multiple myeloma by vincent rajkumar, ola landgren, and mariavictoria mateos frontline therapy of multiple myeloma by philippe moreau, michel attal, and thierry facon treatment options for relapsed and refractory multiple myeloma by ajay k. Multiple myeloma is a cancer of plasma cells that produce monoclonal immunoglobulin and invade and destroy adjacent bone tissue. New drugs introduced in the past few years include carfilzomib, pomalidomide, panobinostat, ixazomib, elotuzumab, and daratumumab. Multiple myeloma early detection, diagnosis, and staging. Multiple myeloma is the malignant counterpart of longlived plasma cells with a strong tropism for bone and bone marrow.
Nov 12, 2015 multiple myeloma and the immune system thursday, november 12, 2015 multiple myeloma and the immune system rafael fonseca, md getz family professor of cancer and professor of medicine mayo clinic distinguished investigator chair, department of medicine scottsdale, az 2. Multiple myeloma early detection, diagnosis, and staging 1. Smoldering multiple myeloma blood american society of. Myeloma is called multiple because it frequently involves multiple areas in the body. Multiple myeloma is a cancer that develops in the bone marrow, the spongy tissue found in the center of most bones.
These are cancerous cells that can multiply uncontrollably. Multiple myeloma merck manuals professional edition. The bone marrow produces red blood cells, which carry oxygen throughout the body. Jul 11, 2016 multiple myeloma accounts for around 1% of all cancers worldwide and 1015% of all hematological neoplasms. Challenges in multiple myeloma diagnosis and treatment.
In 2015, an estimated 28,850 new cases of multiple myeloma were. Monoclonal antibodies in multiple myeloma come of age nejm. Multiple myeloma blood american society of hematology. 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. Multiple myeloma is overall the 14 th most common malignancy but is rarely seen in those younger than 35 years. Single versus double autologous stemcell transplantation for. Multiple myeloma mm is a clonal bcell disease of slowly proliferating plasma cells, accompanied by monoclonal protein production and lytic bone lesions. Comprised of leading medical researchers, hematologist, oncologists, oncologycertified nurses, medical editors, and medical journalists, our team has extensive knowledge of the multiple myeloma treatment and care landscape. Advances in therapy have resulted in a marked improvement in overall survival.
Daratumumab plus lenalidomide and dexamethasone for. The increasing adoption of lenalidomidebased therapy for frontline treatment of multiple myeloma has resulted in a need for effective regimens for lenalidomiderefractory patients. Still, most patients have no affected relatives, so this accounts for only a small number of cases. Multiple myeloma is a cancer that arises from a type of white blood cell called a plasma cell.
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