Nejvíce citovaný článek - PubMed ID 29429912
Denosumab versus zoledronic acid in bone disease treatment of newly diagnosed multiple myeloma: an international, double-blind, double-dummy, randomised, controlled, phase 3 study
Since the publication in 2021 of the European Hematology Association (EHA) Clinical Practice Guidelines for the treatment of patients with smouldering multiple myeloma (SMM) and multiple myeloma (MM), developed in collaboration with the European Society for Medical Oncology, a novel international staging system (R2-ISS) has been developed, several prognostic factors are entering clinical practice (such as minimal residual disease, circulating plasma cells and monoclonal protein assessed by mass spectrometry) and, at the time of writing, 14 novel regimens have been approved by the EMA and/or the FDA for the treatment of patients with MM. A multidisciplinary group of experts from the EHA and European Myeloma Network, based in various institutions mostly located in Europe, have updated the previous guidelines and produced algorithms for everyday clinical practice that incorporate levels of evidence and grades of recommendation based on the aforementioned new data. In these Evidence-Based Guidelines, we provide key treatment recommendations for both patients with newly diagnosed MM and those with relapsed and/or refractory MM, including guidance for the use of established drugs as well as contemporary immunotherapies. Novel approaches for the management of patients with SMM focus on those who might require early intervention. Finally, we provide recommendations for myeloma-related complications and adverse events, such as bone disease, renal impairment and infections, as well as for those associated with T cell-mobilizing therapies, such as cytokine-release syndrome and immune effector cell-associated neurotoxicity syndrome.
- MeSH
- lidé MeSH
- medicína založená na důkazech MeSH
- mnohočetný myelom * diagnóza terapie MeSH
- směrnice pro lékařskou praxi jako téma * MeSH
- staging nádorů MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Multiple myeloma (MM) is a hematological malignancy caused by the clonal expansion of plasma cells. The incidence of MM worldwide is increasing with greater than 140 000 people being diagnosed with MM per year. Whereas 5-year survival after a diagnosis of MM has improved from 28% in 1975 to 56% in 2012, the disease remains essentially incurable. In this review, we summarize our current understanding of MM including its epidemiology, genetics and biology. We will also provide an overview of MM management that has led to improvements in survival, including recent changes to diagnosis and therapies. Areas of unmet need include the management of patients with high-risk MM, those with reduced performance status and those refractory to standard therapies. Ongoing research into the biology and early detection of MM as well as the development of novel therapies, such as immunotherapies, has the potential to influence MM practice in the future.
- Klíčová slova
- clinical presentation, plasma cell disease, risks factors, survival, treatment,
- MeSH
- cyklin D1 genetika MeSH
- exozom genetika MeSH
- genetická predispozice k nemoci MeSH
- histondemethylasy genetika MeSH
- imunoterapie metody MeSH
- lidé MeSH
- míra přežití MeSH
- mnohočetný myelom diagnóza epidemiologie genetika terapie MeSH
- mutace MeSH
- nádorové biomarkery genetika MeSH
- plazmatické buňky imunologie patologie MeSH
- represorové proteiny genetika MeSH
- rizikové faktory MeSH
- transkripční elongační faktory genetika MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
- Názvy látek
- CCND1 protein, human MeSH Prohlížeč
- CDCA7L protein, human MeSH Prohlížeč
- cyklin D1 MeSH
- DIS3 protein, human MeSH Prohlížeč
- ELL2 protein, human MeSH Prohlížeč
- exozom MeSH
- histondemethylasy MeSH
- KDM1A protein, human MeSH Prohlížeč
- nádorové biomarkery MeSH
- represorové proteiny MeSH
- transkripční elongační faktory MeSH