Fundamentals in the management of multiple Myeloma

Research output: Contribution to journalArticle

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Abstract

Progress in our understanding of multiple myeloma and its treatment has resulted in a more tailored approach to patient management, with different therapeutics regimens for different patient populations. The decision to initiate therapy depends primarily on the presence of symptoms which has to balance the chance of tumor clearance and against the risks of treatment related mortality. Selection of appropriate initial treatment should be based primarily on patient's characteristics (biologic age, co-morbidities), the disease characteristics (tumor burden and genetic risk profile) and the expected toxicity profile of the different regimens. When treatment begins, in younger transplant eligible patients the goal is to achieve high quality responses with intensive therapies as the quality of response appears to be important surrogates for long-term outcome. In the majority of myeloma patients in whom intensive treatment is not an option due to advanced age and co-morbidities, treatment should emphasize on optimal disease control to obtain symptomatic relief and to maintain a satisfactory quality of life. The introduction of novel agents has substantially changed the treatment paradigm of this otherwise incurable disease. The utilization of these drugs has moved from relapse setting to the front line setting and has benefited all patient groups. Because of these rapid developments and many treatment options we need good quality clinical studies to guide clinical practice in the management of patients with multiple myeloma. This review presents an update on current concepts of diagnosis and treatment of patients with multiple myeloma and provides recommendations on tailored therapies with particular reference to the local practice. The information presented herein may be used by the health care providers caring for myeloma patients as a guideline to counsel patients to understand their disease and the treatment better.

Original languageEnglish
Pages (from-to)231-239
Number of pages9
JournalMedical Journal of Malaysia
Volume65
Issue number3
Publication statusPublished - Sep 2010

Fingerprint

Multiple Myeloma
Therapeutics
Drug Utilization
Morbidity
Practice Management
Tumor Burden
Health Personnel
Quality of Life
Guidelines

Keywords

  • Bortezomib
  • Lenalidomide
  • Multiple myeloma
  • Paraprotein
  • Thalidomide
  • Treatment

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Fundamentals in the management of multiple Myeloma. / S. Abdul Wahid, S Fadilah.

In: Medical Journal of Malaysia, Vol. 65, No. 3, 09.2010, p. 231-239.

Research output: Contribution to journalArticle

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