Abstract :
[en] The prognosis for patients multiple myeloma (MM) has improved substantially over the past decade with the development of new, more effective chemotherapeutic agents and regimens that possess a high level of anti-tumor activity. In spite of this important progress, however, nearly all MM patients ultimately relapse, even those who experience a complete response to initial therapy. Management of relapsed MM thus represents a vital aspect of the overall care for
patients with MM and a critical area of ongoing scientific and clinical research. This comprehensive manuscript from the International Myeloma Working Group provides detailed
recommendations on management of relapsed disease, with sections dedicated to diagnostic
evaluation, determinants of therapy, and general approach to patients with specific disease
characteristics. In addition, the manuscript provides a summary of evidence from clinical trials
that have significantly impacted the field, including those evaluating conventional dose
therapies, as well as both autologous and allogeneic stem cell transplantation. Specific
recommendations are offered for management of first and second relapse, relapsed and refractory disease, and both autologous and allogeneic transplant. Finally, perspective is provided regarding new agents and promising directions in management of relapsed MM.
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