THE TREATMENT OF MULTIPLE MYELOMA PATIENTS NOT ELIGIBLE FOR ASCT

<p class="MsoNormal" style="margin: 0cm 0cm 0pt; line-height: 150%; mso-layout-grid-align: none;"><span style="font-size: small;"><span style="font-family: ";Arial";,";sans-serif";; mso-ansi-language: EN-GB; ms...

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Main Authors: Anuj Mahindra, Jacob Laubach, Paul Richardson, Constantine Mitsiades, Robert Schlossman, Irene Ghobrial, Teru Hideshima, Noopur Raje, Nikhil Munshi, Kenneth Anderson
Format: Article
Language:English
Published: PAGEPress Publications 2010-05-01
Series:Mediterranean Journal of Hematology and Infectious Diseases
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Online Access:http://www.mjhid.org/article/view/5779
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author Anuj Mahindra
Jacob Laubach
Paul Richardson
Constantine Mitsiades
Robert Schlossman
Irene Ghobrial
Teru Hideshima
Noopur Raje
Nikhil Munshi
Kenneth Anderson
author_facet Anuj Mahindra
Jacob Laubach
Paul Richardson
Constantine Mitsiades
Robert Schlossman
Irene Ghobrial
Teru Hideshima
Noopur Raje
Nikhil Munshi
Kenneth Anderson
author_sort Anuj Mahindra
collection DOAJ
description <p class="MsoNormal" style="margin: 0cm 0cm 0pt; line-height: 150%; mso-layout-grid-align: none;"><span style="font-size: small;"><span style="font-family: ";Arial";,";sans-serif";; mso-ansi-language: EN-GB; mso-fareast-language: EN-GB;" lang="EN-GB">Advances in therapies for younger patients with multiple myeloma have resulted in significant</span><strong style="mso-bidi-font-weight: normal;"><span style="font-family: ";Arial";,";sans-serif";; mso-ansi-language: EN-GB;" lang="EN-GB"> </span></strong><span style="color: black; font-family: ";Arial";,";sans-serif";; mso-ansi-language: EN-GB; mso-fareast-language: EN-GB;" lang="EN-GB">improvements in outcome over recent years,</span><span style="font-family: ";Arial";,";sans-serif";; mso-ansi-language: EN-GB; mso-fareast-language: EN-GB;" lang="EN-GB"> on the contrary the<span style="color: black;"> progress in treatments for elderly patients has remained more modest. Traditionally, patients <span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>who are not eligible for transplantation, like the older patients, <span style="mso-spacerun: yes;"> </span>have been treated with the combination of melphalan plus prednisone (MP), which leads to responses in approximately 50% of patients; however, patients rarely achieve a complete response (CR) and long-term outcomes are disappointing, with a relapse-free survival of approximately 18 months and an overall survival (OS) of approximately 3 years.</span></span></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt; line-height: 150%; mso-layout-grid-align: none;"><span style="color: black; font-family: ";Arial";,";sans-serif";; mso-ansi-language: EN-GB; mso-fareast-language: EN-GB;" lang="EN-GB"><span style="font-size: small;">With the arrival of novel agents, including the first–in-class proteasome inhibitor, bortezomib, and the immunomodulatory agents, thalidomide and lenalidomide, a shift in the management of older patients and/or those not eligible for transplantation has taken place. Increasingly, novel agents are now being incorporated into therapy, based on the positive findings from clinical trials in this setting, and outcomes have improved accordingly.</span></span></p>
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spelling doaj-art-73c5faa66eac4af586348da8c403d09e2025-08-20T02:51:00ZengPAGEPress PublicationsMediterranean Journal of Hematology and Infectious Diseases2035-30062010-05-0122e2010009e2010009THE TREATMENT OF MULTIPLE MYELOMA PATIENTS NOT ELIGIBLE FOR ASCTAnuj MahindraJacob LaubachPaul RichardsonConstantine MitsiadesRobert SchlossmanIrene GhobrialTeru HideshimaNoopur RajeNikhil MunshiKenneth Anderson<p class="MsoNormal" style="margin: 0cm 0cm 0pt; line-height: 150%; mso-layout-grid-align: none;"><span style="font-size: small;"><span style="font-family: ";Arial";,";sans-serif";; mso-ansi-language: EN-GB; mso-fareast-language: EN-GB;" lang="EN-GB">Advances in therapies for younger patients with multiple myeloma have resulted in significant</span><strong style="mso-bidi-font-weight: normal;"><span style="font-family: ";Arial";,";sans-serif";; mso-ansi-language: EN-GB;" lang="EN-GB"> </span></strong><span style="color: black; font-family: ";Arial";,";sans-serif";; mso-ansi-language: EN-GB; mso-fareast-language: EN-GB;" lang="EN-GB">improvements in outcome over recent years,</span><span style="font-family: ";Arial";,";sans-serif";; mso-ansi-language: EN-GB; mso-fareast-language: EN-GB;" lang="EN-GB"> on the contrary the<span style="color: black;"> progress in treatments for elderly patients has remained more modest. Traditionally, patients <span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>who are not eligible for transplantation, like the older patients, <span style="mso-spacerun: yes;"> </span>have been treated with the combination of melphalan plus prednisone (MP), which leads to responses in approximately 50% of patients; however, patients rarely achieve a complete response (CR) and long-term outcomes are disappointing, with a relapse-free survival of approximately 18 months and an overall survival (OS) of approximately 3 years.</span></span></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt; line-height: 150%; mso-layout-grid-align: none;"><span style="color: black; font-family: ";Arial";,";sans-serif";; mso-ansi-language: EN-GB; mso-fareast-language: EN-GB;" lang="EN-GB"><span style="font-size: small;">With the arrival of novel agents, including the first–in-class proteasome inhibitor, bortezomib, and the immunomodulatory agents, thalidomide and lenalidomide, a shift in the management of older patients and/or those not eligible for transplantation has taken place. Increasingly, novel agents are now being incorporated into therapy, based on the positive findings from clinical trials in this setting, and outcomes have improved accordingly.</span></span></p>http://www.mjhid.org/article/view/5779Myeloma,New Drugs, Older People, Bortezomid, Thalidomide, Revlimid
spellingShingle Anuj Mahindra
Jacob Laubach
Paul Richardson
Constantine Mitsiades
Robert Schlossman
Irene Ghobrial
Teru Hideshima
Noopur Raje
Nikhil Munshi
Kenneth Anderson
THE TREATMENT OF MULTIPLE MYELOMA PATIENTS NOT ELIGIBLE FOR ASCT
Mediterranean Journal of Hematology and Infectious Diseases
Myeloma,New Drugs, Older People, Bortezomid, Thalidomide, Revlimid
title THE TREATMENT OF MULTIPLE MYELOMA PATIENTS NOT ELIGIBLE FOR ASCT
title_full THE TREATMENT OF MULTIPLE MYELOMA PATIENTS NOT ELIGIBLE FOR ASCT
title_fullStr THE TREATMENT OF MULTIPLE MYELOMA PATIENTS NOT ELIGIBLE FOR ASCT
title_full_unstemmed THE TREATMENT OF MULTIPLE MYELOMA PATIENTS NOT ELIGIBLE FOR ASCT
title_short THE TREATMENT OF MULTIPLE MYELOMA PATIENTS NOT ELIGIBLE FOR ASCT
title_sort treatment of multiple myeloma patients not eligible for asct
topic Myeloma,New Drugs, Older People, Bortezomid, Thalidomide, Revlimid
url http://www.mjhid.org/article/view/5779
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