High risk multiple myeloma

Abstract

Multiple myeloma is a very heterogeneous disease. Though distinctive, several subgroups of the disease have been identified basing on pathological and clinical features. It is generally accepted that high risk myeloma could be defined as a subtype of disease leading to death within 24 months. Many prognostic parameters help to identify high risk myeloma including age, renal insufficiency, comorbities, proliferation activity and genetic abnormalities. Basing on selective prognostic factors, some risk stratification and risk adapted therapies were proposed by European and American study groups, but the results of therapy are still unsatisfactory. It is suggested that patients with high risk myeloma should probably benefit from dose-dense and prolonged therapy including novel drugs being in the clinical trials.