Current approaches to management of high-risk multiple myeloma

The median overall survival in multiple myeloma is rapidly approaching 10 years; however, in nearly a fifth of patients the prognosis remains poor. Therefore, the modern-day management of myeloma patients should be individualized, with a more intense and continuous approach in these high-risk patients. This includes first-line treatment based on multi-drug combinations employing the most effective drug combinations, upfront autologous stem cell transplantation (in eligible patients with tandem transplantation being a consideration), and maintenance based on proteasome inhibitor-based combinations. This paper reviews the results of recent retrospective analyses and clinical trials, but also gives a glance into the future by presenting the ongoing trials.

Automated summary

The median overall survival for multiple myeloma patients is nearly 10 years, but a significant percentage still have poor prognosis. Therefore, individualized and intensive treatment approaches should be utilized, especially for high-risk patients. This includes using effective drug combinations, considering autologous stem cell transplantation, and maintenance based on proteasome inhibitor-based combinations.