TY - JOUR
T1 - International Myeloma Working Group Consensus Statement for the Management, Treatment, and Supportive Care of Patients With Myeloma Not Eligible for Standard Autologous Stem-Cell Transplantation
AU - Palumbo, A
AU - Rajkumar, SV
AU - San Miguel, JF
AU - Larocca, A
AU - Niesvizky, R
AU - Morgan, G
AU - Landgren, O
AU - Hajek, R
AU - Einsele, H
AU - Anderson, KC
AU - Dimopoulos, MA
AU - Richardson, PG
AU - Cavo, M
AU - Spencer, A
AU - Stewart, AK
AU - Shimizu, K
AU - Lonial, S
AU - Sonneveld, Pieter
AU - Durie, BGM
AU - Moreau, P
AU - Orlowski, RZ
PY - 2014
Y1 - 2014
N2 - Purpose To provide an update on recent advances in the management of patients with multiple myeloma who are not eligible for autologous stem-cell transplantation. Methods A comprehensive review of the literature on diagnostic criteria is provided, and treatment options and management of adverse events are summarized. Results Patients with symptomatic disease and organ damage (ie, hypercalcemia, renal failure, anemia, or bone lesions) require immediate treatment. The International Staging System and chromosomal abnormalities identify high- and standard-risk patients. Proteasome inhibitors, immunomodulatory drugs, corticosteroids, and alkylating agents are the most active agents. The presence of concomitant diseases, frailty, or disability should be assessed and, if present, treated with reduced-dose approaches. Bone disease, renal damage, hematologic toxicities, infections, thromboembolism, and peripheral neuropathy are the most frequent disabling events requiring prompt and active supportive care. Conclusion These recommendations will help clinicians ensure the most appropriate care for patients with myeloma in everyday clinical practice. (C) 2014 by American Society of Clinical Oncology
AB - Purpose To provide an update on recent advances in the management of patients with multiple myeloma who are not eligible for autologous stem-cell transplantation. Methods A comprehensive review of the literature on diagnostic criteria is provided, and treatment options and management of adverse events are summarized. Results Patients with symptomatic disease and organ damage (ie, hypercalcemia, renal failure, anemia, or bone lesions) require immediate treatment. The International Staging System and chromosomal abnormalities identify high- and standard-risk patients. Proteasome inhibitors, immunomodulatory drugs, corticosteroids, and alkylating agents are the most active agents. The presence of concomitant diseases, frailty, or disability should be assessed and, if present, treated with reduced-dose approaches. Bone disease, renal damage, hematologic toxicities, infections, thromboembolism, and peripheral neuropathy are the most frequent disabling events requiring prompt and active supportive care. Conclusion These recommendations will help clinicians ensure the most appropriate care for patients with myeloma in everyday clinical practice. (C) 2014 by American Society of Clinical Oncology
U2 - 10.1200/JCO.2013.48.7934
DO - 10.1200/JCO.2013.48.7934
M3 - Article
C2 - 24419113
SN - 0732-183X
VL - 32
SP - 587-+
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 6
ER -