open access

Vol 48, No 2 (2017)
Prace poglądowe / Reviews
Published online: 2017-04-01
Submitted: 2017-04-24
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Different induction regimens for myeloma patients eligible for high-dose chemotherapy followed by autologous stem cell transplantations and Polish Myeloma Group current recommendations

Agnieszka Druzd-Sitek, Jan Walewski1
DOI: 10.1016/j.achaem.2017.06.001
·
Acta Haematol Pol 2017;48(2):104-111.
Affiliations
  1. Klinika Nowotworów Układu Chłonnego Centrum Onkologii-Instytut im. M. Skłodowskiej-Curie, Warszawa, Polska

open access

Vol 48, No 2 (2017)
Prace poglądowe / Reviews
Published online: 2017-04-01
Submitted: 2017-04-24

Abstract

Despite significant progress in the treatment of multiple myeloma, it still remains an incurable disease. The introduction of new drugs has contributed to the increased overall survival of patients diagnosed with multiple myeloma and significantly improved their quality of life. Proteasome inhibitors, immunomodulators and monoclonal antibodies are often used in combination with chemotherapeutic agents. Despite the indisputable role of the new drugs for the treatment of myeloma, high-dose chemotherapy with autologous stem cell transplantation is still the method of choice in a group of younger patients without significant comorbidities. Induction treatment in myeloma patients eligible for autologous stem cell transplantation is particularly important, because the results of the first-line therapy impact further outcome of patients. The quality of the response to first-line treatment determines the progression-free survival. The choice of bortezomib, thalidomide, dexamethasone regimen as induction therapy, recommended by the Polish Myeloma Group, is in line with the recommendations of international experts. The results of the randomized clinical trials have demonstrated that the triple therapy, based on proteasom inhibitors, immunomodulators and steroids, is more effective than regimens involving two drugs only (proteasom inhibitors and steroids or immunomodulators and steroids). Sometimes, due to the clinical situation of the patient and/or unusual features of the disease, it is necessary to individualize induction therapy. The following article provides an overview of different induction regimens for myeloma patients in Poland and suggestions for modifications in justified cases.

Abstract

Despite significant progress in the treatment of multiple myeloma, it still remains an incurable disease. The introduction of new drugs has contributed to the increased overall survival of patients diagnosed with multiple myeloma and significantly improved their quality of life. Proteasome inhibitors, immunomodulators and monoclonal antibodies are often used in combination with chemotherapeutic agents. Despite the indisputable role of the new drugs for the treatment of myeloma, high-dose chemotherapy with autologous stem cell transplantation is still the method of choice in a group of younger patients without significant comorbidities. Induction treatment in myeloma patients eligible for autologous stem cell transplantation is particularly important, because the results of the first-line therapy impact further outcome of patients. The quality of the response to first-line treatment determines the progression-free survival. The choice of bortezomib, thalidomide, dexamethasone regimen as induction therapy, recommended by the Polish Myeloma Group, is in line with the recommendations of international experts. The results of the randomized clinical trials have demonstrated that the triple therapy, based on proteasom inhibitors, immunomodulators and steroids, is more effective than regimens involving two drugs only (proteasom inhibitors and steroids or immunomodulators and steroids). Sometimes, due to the clinical situation of the patient and/or unusual features of the disease, it is necessary to individualize induction therapy. The following article provides an overview of different induction regimens for myeloma patients in Poland and suggestions for modifications in justified cases.

Get Citation

Keywords

Plasma cell myeloma; Proteasome inhibitors; Immunomodulators; Stem cell autotransplantation.

About this article
Title

Different induction regimens for myeloma patients eligible for high-dose chemotherapy followed by autologous stem cell transplantations and Polish Myeloma Group current recommendations

Journal

Acta Haematologica Polonica

Issue

Vol 48, No 2 (2017)

Pages

104-111

Published online

2017-04-01

DOI

10.1016/j.achaem.2017.06.001

Bibliographic record

Acta Haematol Pol 2017;48(2):104-111.

Keywords

Plasma cell myeloma
Proteasome inhibitors
Immunomodulators
Stem cell autotransplantation.

Authors

Agnieszka Druzd-Sitek
Jan Walewski

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