Fast Five Quiz: Key Aspects of Multiple Myeloma

Emmanuel C. Besa, MD


September 26, 2019

According to ESMO guidelines, the following are considered major treatment regimens in patients with multiple myeloma:

  • VMP

  • Lenalidomide/low-dose dexamethasone (Rd)

  • Melphalan/prednisone/thalidomide (MPT)

  • Bortezomib/cyclophosphamide/dexamethasone (VCD)

  • Bortezomib/thalidomide/dexamethasone (VTD)

  • Bortezomib/lenalidomide/dexamethasone (VRd)

Although studies are ongoing, the ESMO guidelines at the present time do not recommend immediate treatment for patients with indolent myeloma.

In elderly patients who are not undergoing transplantation, ESMO recommends VMP or Rd. CTD has been compared with MP and is superior in terms of response rates but does not induce a clear survival advantage over MP.

For younger patients (< 65 years) or fit patients younger than 70 years in good clinical condition, induction followed by high-dose therapy with ASCT is the standard treatment. Bortezomib-dexamethasone, which is superior to the classic vincristine, doxorubicin, and high-dose dexamethasone (VAD) regimen, has become the backbone of induction therapy before ASCT.

Read more about the treatment of multiple myeloma.

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