Considerations in the treatment of multiple myeloma: A consensus statement from Italian experts

Francesca Patriarca, Maria T. Petrucci, Sara Bringhen, Luca Baldini, Tommaso Caravita, Paolo Corradini, Alessandro Corso, Francesco Di Raimondo, Antonietta Falcone, Felicetto Ferrara, Fortunato Morabito, Pellegrino Musto, Massimo Offidani, Mario Petrini, Rita Rizzi, Gianpietro Semenzato, Patrizia Tosi, Angelo Vacca, Michele Cavo, Mario BoccadoroAntonio Palumbo

Research output: Contribution to journalArticle

Abstract

Purpose and basic procedure of the study: The availability of new targeted therapies has revolutionised the treatment of multiple myeloma (MM), for both the newly diagnosed and the relapsed and refractory settings. A panel of Italian experts provided guidelines for optimal clinical practice in the treatment of MM. Main findings and conclusions: The panel recommended that treatment should only be initiated in symptomatic patients. Autologous stem cell transplantation (ASCT) with melphalan is the treatment of choice in patients younger than 65 yr, and induction therapy including new drugs seems the most suitable preparatory regimen before ASCT. In patients who fail to achieve at least a very good partial response (VGPR) after transplant, a consolidation with a second transplant is of clinical benefit. Also, there is evidence that maintenance with thalidomide after ASCT in young patients failing to reach at least VGPR could prolong survival. In elderly patients, the combination of an alkylating drug with a novel agent should be considered as standard approach. Relapsed MM should be retreated after the reappearance of symptoms and signs of organ and tissue damage. Salvage regimens should include corticosteroids plus bortezomib, thalidomide or lenalidomide.

Original languageEnglish
Pages (from-to)93-105
Number of pages13
JournalEuropean Journal of Haematology
Volume82
Issue number2
DOIs
Publication statusPublished - Feb 2009

Keywords

  • Chemotherapy
  • Clinical practice guidelines
  • Myeloma
  • Transplantation

ASJC Scopus subject areas

  • Hematology

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    Patriarca, F., Petrucci, M. T., Bringhen, S., Baldini, L., Caravita, T., Corradini, P., Corso, A., Di Raimondo, F., Falcone, A., Ferrara, F., Morabito, F., Musto, P., Offidani, M., Petrini, M., Rizzi, R., Semenzato, G., Tosi, P., Vacca, A., Cavo, M., ... Palumbo, A. (2009). Considerations in the treatment of multiple myeloma: A consensus statement from Italian experts. European Journal of Haematology, 82(2), 93-105. https://doi.org/10.1111/j.1600-0609.2008.01179.x