Risk adapted post-transplant maintenance in multiple myeloma

Expert Rev Hematol. 2019 Feb;12(2):107-118. doi: 10.1080/17474086.2019.1576521.

Abstract

The survival of multiple myeloma patients is increasing due to new medications, the widespread implementation of autologous stem cell transplantation and better supportive treatments. The controversy surrounding post-transplant treatment is debated due to a lack of large randomized trials comparing the different treatment modalities. The questions for each proposed treatment are whether it improves outcomes, has low cumulative toxicities and is easy to administer. Areas covered: In this review, we have summarized the current data on maintenance therapy in newly diagnosed MM patients undergoing ASCT, focusing on bortezomib, thalidomide and lenalidomide as well as newer agents Expert opinion: Maintenance treatment has been shown to deepen and prolong responses and increase PFS and OS. Lenalidomide is approved for maintenance and guidelines recommend its use post ASCT. Ixazomib has recently been reported to improve PFS.

Keywords: Maintenance therapy; bortezomib; lenalidomide; multiple myeloma; risk-adapted; thalidomide.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Antineoplastic Agents / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bortezomib / therapeutic use*
  • Hematopoietic Stem Cell Transplantation / methods*
  • Humans
  • Lenalidomide / therapeutic use*
  • Maintenance Chemotherapy / methods
  • Multiple Myeloma / therapy*
  • Thalidomide / therapeutic use*
  • Transplantation, Autologous

Substances

  • Antineoplastic Agents
  • Thalidomide
  • Bortezomib
  • Lenalidomide