Vol 13, No 2 (2022)
Review paper
Published online: 2022-10-20
Optimization of treatment of patients with plasma cell myeloma with high cytogenetic risk in Poland
12
, 3, 4, 5
, 3, 4, 5
Hematology in Clinical Practice 2022;13(2):41-48.
Abstract
Plasma cell myeloma (PCM) is a hematologic malignancy that derives from mature B cells. The prognosis of patients with PCM is highly dependent on the presence of cytogenetic aberrations. Determination of cytogenetic risk enables informing patients about their prognosis and allows for individual choice of therapy. In Poland, cytogenetic risk assessment is a fully reimbursed procedure, and it is recommended to perform such an examination in every diagnosed patient. Therapy of patients with high cytogenetic risk should be planned with consideration of tandem autotransplantation of hematopoietic cells in eligible patients. In patients with refractory or relapsed PCM, treatment with ixazomib in combination with lenalidomide and dexamethasone appears to remove cytogenetic risk.
Keywords: multiple myelomaplasma cell myelomarefractory multiple myelomarelapsed multiple myelomacytogenetic risktherapy
References
- van de Donk NW, Pawlyn C, Yong K. Multiple myeloma. Lancet. 2021; 397(10272): 410–427.
- http://onkologia.org.pl/raporty/. Nowotwory złośliwe w Polsce w 2018 roku. Krajowy Rejestr Nowotworów, Warszawa 2020 (April 7, 2022).
- cancer net/cancer-types/multiple-myeloma/statistics. American Society of Clinical Oncology (ASCO) Multiple Myeloma: Statistics (April 7, 2022).
- Zalecenia Polskiej Grupy Szpiczakowej dotyczące rozpoznawania i leczenia szpiczaka plazmocytowego oraz innych dyskrazji plazmocytowych na rok 2021. http://szpiczak.org/wp-content/uploads/aktualnosci/2021/ZALECENIA-2021-PGSZ.pdf (April 7, 2022).
- Padala SA, Barsouk A, Barsouk A, et al. Epidemiology, staging, and management of multiple myeloma. Med Sci (Basel). 2021; 9(1).
- Ghobrial IM, Landgren O. How I treat smoldering multiple myeloma. Blood. 2014; 124(23): 3380–3388.
- van de Donk NW, Palumbo A, Johnsen HE, et al. European Myeloma Network. The clinical relevance and management of monoclonal gammopathy of undetermined significance and related disorders: recommendations from the European Myeloma Network. Haematologica. 2014; 99(6): 984–996.
- Rajkumar S, Kyle R, Therneau T, et al. Serum free light chain ratio is an independent risk factor for progression in monoclonal gammopathy of undetermined significance. Blood. 2005; 106(3): 812–817.
- Palumbo A, Avet-Loiseau H, Oliva S, et al. Revised International Staging System for Multiple Myeloma: a report From International Myeloma Working Group. J Clin Oncol. 2015; 33(26): 2863–2869.
- Kumar SK, Mikhael JR, Buadi FK, et al. Management of newly diagnosed symptomatic multiple myeloma: updated Mayo Stratification of Myeloma and Risk-Adapted Therapy (mSMART) consensus guidelines. Mayo Clin Proc. 2009; 84(12): 1095–1110.
- Rajan AM, Rajkumar SV. Interpretation of cytogenetic results in multiple myeloma for clinical practice. Blood Cancer J. 2015; 5: e365.
- Mikhael JR, Dingli D, Roy V, et al. Mayo Clinic. Management of newly diagnosed symptomatic multiple myeloma: updated Mayo Stratification of Myeloma and Risk-Adapted Therapy (mSMART) consensus guidelines 2013. Mayo Clin Proc. 2013; 88(4): 360–376.
- Program Lekowy, Załącznik B.54. Leczenie chorych na opornego lub nawrotowego szpiczaka plazmocytowego (ICD10 C90.0). https://hematoonkologia.pl/upload/programy-lekowe/B.54._(od_05-2021).pdf (April 7, 2022).
- Wyniki ankiety przeprowdzanej przez Fundację Carita 25.01.2022.
- Cavo M, Gay FM, Patriarca F, et al. Double autologous stem cell transplantation significantly prolongs progression-free survival and overall survival in comparison with single autotransplantation in newly diagnosed multiple myeloma: an analysis of phase 3 EMN02/H095 study. Abstract #401. Presented at the 2017 American Society of Hematology Annual Meeting Atlanta, GA, December 10, 2017.
- Gagelmann N, Eikema DJ, Koster L, et al. Tandem autologous stem cell transplantation improves outcomes in newly diagnosed multiple myeloma with extramedullary disease and high-risk cytogenetics: a study from the Chronic Malignancies Working Party of the European Society for Blood and Marrow Transplantation. Biol Blood Marrow Transplant. 2019; 25(11): 2134–2142.
- Avet-Loiseau H, Fonseca R, Siegel D, et al. Carfilzomib significantly improves the progression-free survival of high-risk patients in multiple myeloma. Blood. 2016; 128(9): 1174–1180.
- Chng WJ, Goldschmidt H, Dimopoulos MA, et al. Carfilzomib–dexamethasone vs bortezomib–dexamethasone in relapsed or refractory multiple myeloma by cytogenetic risk in the phase 3 study ENDEAVOR. Leukemia. 2016; 31(6): 1368–1374.
- Orlowski RZ, Moreau P, Niesvizky R, et al. Carfilzomib-dexamethasone versus bortezomib-dexamethasone in relapsed or refractory multiple myeloma: updated overall survival, safety, and subgroups. Clin Lymphoma Myeloma Leuk. 2019; 19(8): 522–530.e1.
- Weisel K, Nooka AK, Terpos E, et al. CASTOR Investigators. Daratumumab, bortezomib, and dexamethasone for multiple myeloma. N Engl J Med. 2016; 375(8): 754–766.
- Dimopoulos MA, Weisel KC, Song KW, et al. Cytogenetics and long-term survival of patients with refractory or relapsed and refractory multiple myeloma treated with pomalidomide and low-dose dexamethasone. Haematologica. 2015; 100(10): 1327–1333.
- Moreau P, Masszi T, Grzasko N, et al. Oral ixazomib, lenalidomide, and dexamethasone for multiple myeloma. N Engl J Med. 2016; 374(17): 1621–1634.
- Avet-Loiseau H, Hulin C, Campion L, et al. Chromosomal abnormalities are major prognostic factors in elderly patients with multiple myeloma: the intergroupe francophone du myélome experience. J Clin Oncol. 2013; 31(22): 2806–2809.
