[Multibilly]

New Mayo treatment guidelines for relapsed myeloma

by Multibilly on Sun Mar 19, 2017 8:50 pm

Newly published article from the Mayo. It's a bit long, but contains very good overviews on all of the current drugs, risk factors and suggested treatments for myeloma patients in relapse.

Dingli, D, et al, "Therapy for Relapsed Multiple Myeloma - Guidelines From the Mayo Stratification for Myeloma and Risk-Adapted Therapy," Mayo Clinic Proceedings, March 10, 2017 (full text of article).

[Nancy Shamanna]

Re: New Mayo treatment guidelines for relapsed myeloma

by Nancy Shamanna on Mon Mar 20, 2017 1:17 am

Thanks Multibilly for the excellent article about how to treat relapsed patients. It is quite long, but seems to cover most scenarios, from a first relapse onwards. The availability of more novel agents makes the decisions more complicated, but also with a better chance of success, I think.

[coachhoke]

Re: New Mayo treatment guidelines for relapsed myeloma

by coachhoke on Tue Mar 21, 2017 6:27 am

Thanks Multibilly, it's a good read. I am surprised that they feel strongly that an autologous stem cell transplant (ASCT) is the treatment of choice, both for initial treatment and those experiencing an indolent relapse. They also state that "the duration of therapy in patients with relapsed multiple myeloma is not well defined." I think that's a big issue. Instead of "continuing therapy until they relapse or progress on second-line therapy or they develop significant toxicity" it would be great if therapy could be administered only as needed.

[goldmine848]

Re: New Mayo treatment guidelines for relapsed myeloma

by goldmine848 on Tue Mar 21, 2017 10:19 pm

I found this newly revised set of guidelines interesting as well. One of the important issues pre­sented by the variability of the disease, coupled with the many new treatments, is how to select a treatment regimen on relapse. While not definitively answering the question, the guidelines provide some important criteria for narrowing down the choices.