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Key Points
➤ In 2018, an estimated 30,770 new cases of multiple myeloma will be
diagnosed in the United States, representing 1.8% of all new cancer
cases.
➤ The estimated number of deaths from multiple myeloma in 2018 is
12,770, representing 2.1% of all cancer deaths.
➤ Despite significant advances and improvements in overall survival,
multiple myeloma remains incurable and additional treatments are
needed.
➤ The median survival is just over 5 years and most patients receive 4
or more different lines of therapy throughout their disease course.
Transplant Eligible
➤ Patients should be referred to a transplant center to determine
transplant eligibility. (Moderate Recommendation; EB-I-B)
➤ Chronologic age and renal function should not be the sole criteria
used to determine eligibility for stem cell transplantation (SCT).
(Moderate Recommendation; EB-I-B)
➤ The optimal regimen and number of cycles remain unproven.
However, at least 3-4 cycles of induction therapy including an
immunomodulatory drug, proteasome inhibitor and steroids is
advised prior to stem cell collection. (Moderate Recommendation;
EB-I-B)
➤ Upfront transplant should be offered to all transplant-eligible
patients. Delayed initial SCT may be considered in select patients.
(Strong Recommendation; EB-H-B)
➤ Agents associated with stem cell toxicity, such as melphalan and/or
prolonged immunomodulatory drugs exposure (more than 4 cycles),
should be avoided in patients who are potential candidates for SCT.
(Moderate Recommendation; EB-I-B)
Treatment
