[Pat Killingsworth]

Treating High Risk Multiple Myeloma

by Pat Killingsworth on Mon Jun 21, 2010 8:43 am

If it isn't too late, I have a question for Dr. Berenson. Could you give some examples of how high risk myeloma patients would or should be treated differently than a low risk patient? Thank you- Pat

[Dr. Craig Hofmeister]

Re: Treating High Risk Multiple Myeloma

by Dr. Craig Hofmeister on Tue Sep 07, 2010 5:33 pm

I'm not Dr. Berenson, but I think the overall feeling is that for patients that are truly high risk (high beta2 microglobulin + high risk genetics such as 17p deletion or t(14;16)), all treatments are going to work only transiently and maintenance of response will quickly become impossible. The development of highly effective new therapies is critical for these patients with very proliferative disease.

For the intermediate risk patient, the longer and more intense the treatment, the longer the patient will not suffer demise related to myeloma. There is certainly a trade off her between quality of life and intensity of treatment.

Lastly, all the talk really is about low risk patients with the schemata from Dr. Vincent Rajkumar's "cure vs. control" really applies. In these patients, even in Arksansas, dose-reduced autologous transplants are being performed and two-drug instead of three-drug therapy is preferred.