Vol 5, No 4 (2014)
Review paper
Published online: 2015-03-06

open access

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Plasma cell myeloma — practical aspects of the diagnosis and treatment

Grzegorz Charliński, Elżbieta Wiater
Hematologia 2014;5(4):317-331.

Abstract

Understanding of the biology of plasma cell myeloma (PCM) and the introduction of new drugs for the treatment of this disease has changed the perception of disease. Accurate diagnosis of PCM and application therapy based on immunomodulatory drugs or proteasome inhibitors can achieve long-term response to treatment, progression-free survival and overall survival increases. At the same time, the introduction of novel diagnostic methods and improvement the results of treatment led to the introduction of new definitions, which define the response to therapy, as immunophenotyping or molecular complete remission. Patients ineligible for autologous hematopoietic stem cell transplantation (auto-HSCT) are used to treat with the therapy based on bortezomib or thalidomide in combination with melphalan and corticosteroids, while inducing protocols in patients eligible for auto-HSCT contain usually three drugs including bortezomib and corticosteroids. Treatment of older patients requires individualization particularly with regard to the doses of medications. The introduction of novel diagnostic methods, the definition of new prognostic factors and the introduc­tion of modern therapy of PCM will further improve the prognosis of these patients.




Hematology in Clinical Practice