Garderet, L, Cook, G, Auner, HW et al. (12 more authors) (2016) Treatment options for relapse after autograft in multiple myeloma – report from an EBMT educational meeting. Leukemia & Lymphoma, 58 (4). pp. 797-808. ISSN 1042-8194
Abstract
Major improvements have been made in the treatment of myeloma. However, all patients, perhaps with some exceptions, eventually relapse, even after autologous stem cell transplantation (ASCT). In that setting, the combinations of new drugs, namely the IMiDs and the proteasome inhibitors along with steroids, give encouraging results in relapsed patients. The median progression-free survival (PFS) is 20 months with lenalidomide plus dexamethasone plus ixazomib and 26 months with lenalidomide plus dexamethasone plus carfilzomib. Monoclonal antibodies have emerged as an additional new treatment option. The antibody anti-SLAMF7, elotuzumab, in combination with lenalidomide plus dexamethasone gives a median PFS of 20 months. The antibody daratumumab, targeting CD38, alone has an outstanding activity in previously heavily treated patients. Its use in combination is ongoing. Transplantation remains a major treatment option. For patients who relapse at least 18 months from the initial ASCT, a second ASCT can be performed with an expected time to progression of 19 months from the time of transplantation. For patients relapsing earlier and/or with high-risk characteristics and who are still chemosensitive, with a suitable donor, an allogeneic transplantation can be considered. The optimal treatment combination and sequence remain to be determined.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Keywords: | Myeloma, relapse, proteasome inhibitors, immunomodulatory drugs, monoclonal antibodies, autologous stem cell transplantation, allogeneic stem cell transplantation |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > Institute of Molecular Medicine (LIMM) (Leeds) > Section of Oncology and Clinical Research (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 31 Jan 2017 10:02 |
Last Modified: | 11 Jan 2023 12:54 |
Published Version: | https://doi.org/10.1080/10428194.2016.1228926 |
Status: | Published |
Publisher: | Taylor & Francis |
Identification Number: | 10.1080/10428194.2016.1228926 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:111343 |