This Policy Review presents the International Myeloma Working Group's clinical practice recommendations for the treatment of relapsed and refractory multiple myeloma. Based on the results of phase 2 and phase 3 trials, these recommendations are proposed for the treatment of patients with relapsed and refractory disease who have received one previous line of therapy, and for patients with relapsed and refractory multiple myeloma who have received two or more previous lines of therapy. These recommendations integrate the issue of drug access in both low-income and middle-income countries and in high-income countries to help guide real-world practice and thus improve patient outcomes.

• MeSH
• antitumorózní látky terapeutické užití   MeSH
• chemorezistence účinky léků   MeSH
• lidé MeSH
• lokální recidiva nádoru farmakoterapie   patologie   MeSH
• mnohočetný myelom farmakoterapie   patologie   MeSH
• směrnice pro lékařskou praxi jako téma normy   MeSH
• záchranná terapie * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Patients with multiple myeloma (MM) seem to be at increased risk for more severe COVID-19 infection and associated complications due to their immunocompromised state, the older age and comorbidities. The European Myeloma Network has provided an expert consensus statement in order to guide therapeutic decisions in the era of the COVID-19 pandemic. Patient education for personal hygiene and social distancing measures, along with treatment individualization, telemedicine and continuous surveillance for early diagnosis of COVID-19 are essential. In countries or local communities where COVID-19 infection is widely spread, MM patients should have a PCR test of nasopharyngeal swab for SARS-CoV-2 before hospital admission, starting a new treatment line, cell apheresis or ASCT in order to avoid ward or community spread and infections. Oral agent-based regimens should be considered, especially for the elderly and frail patients with standard risk disease, whereas de-intensified regimens for dexamethasone, bortezomib, carfilzomib and daratumumab should be used based on patient risk and response. Treatment initiation should not be postponed for patients with end organ damage, myeloma emergencies and aggressive relapses. Autologous (and especially allogeneic) transplantation should be delayed and extended induction should be administered, especially in standard risk patients and those with adequate MM response to induction. Watchful waiting should be considered for standard risk relapsed patients with low tumor burden, and slow biochemical relapses. The conduction of clinical trials should continue with appropriate adaptations to the current circumstances. Patients with MM and symptomatic COVID-19 disease should interrupt anti-myeloma treatment until recovery. For patients with positive PCR test for SARS-CoV-2, but with no symptoms for COVID-19, a 14-day quarantine should be considered if myeloma-related events allow the delay of treatment. The need for surveillance for drug interactions due to polypharmacy is highlighted. The participation in international COVID-19 cancer registries is greatly encouraged.

• MeSH
• Betacoronavirus izolace a purifikace   MeSH
• čas zasáhnout při rozvinutí nemoci statistika a číselné údaje   MeSH
• kontrola infekce metody   MeSH
• koronavirové infekce epidemiologie   prevence a kontrola   přenos   virologie   MeSH
• lidé MeSH
• management nemoci MeSH
• mnohočetný myelom terapie   virologie   MeSH
• pandemie prevence a kontrola   MeSH
• směrnice pro lékařskou praxi jako téma normy   MeSH
• telemedicína * MeSH
• virová pneumonie epidemiologie   prevence a kontrola   přenos   virologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• Evropa MeSH

• MeSH
• erythropoetin škodlivé účinky   terapeutické užití   MeSH
• hypochromní anemie farmakoterapie   etiologie   MeSH
• nádory komplikace   psychologie   MeSH
• výsledek terapie MeSH
• Publikační typ
• kongresy MeSH
• sborníky MeSH

• Konspekt
• Farmacie. Farmakologie
• NLK Obory
• farmakoterapie
• onkologie