Title |
Treatment of multiple myeloma with high-risk cytogenetics: a consensus of the International Myeloma Working Group
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Published in |
Blood, March 2016
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DOI | 10.1182/blood-2016-01-631200 |
Pubmed ID | |
Authors |
Pieter Sonneveld, Hervé Avet-Loiseau, Sagar Lonial, Saad Usmani, David Siegel, Kenneth C Anderson, Wee-Joo Chng, Philippe Moreau, Michel Attal, Robert A Kyle, Jo Caers, Jens Hillengass, Jesús San Miguel, Niels W C J van de Donk, Hermann Einsele, Joan Bladé, Brian G M Durie, Hartmut Goldschmidt, María-Victoria Mateos, Antonio Palumbo, Robert Orlowski |
Abstract |
The International Myeloma Working Group consensus updates the definition for high-risk multiple myeloma based on cytogenetics Several cytogenetic abnormalities such as t(4;14), del(17/17p), t(14;16), t(14;20), non-hyperdiploidy and gain(1q) were identified that confer poor prognosis. The prognosis of patients showing these abnormalities may vary with the choice of therapy. Treatment strategies that have shown promise for high risk cytogenetic diseases, such as proteasome inhibitor in combination with lenalidomide/pomalidomide, double autologous stem cell transplant plus bortezomib, or combination of immunotherapy with lenalidomide or pomalidomide. Careful analysis of cytogenetic subgroups in trials comparing different treatments remains an important goal. Cross trial comparisons may provide insight in the effect of new drugs in patients with cytogenetic abnormalities. However, in order to achieve this, consensus on definitions of analytical techniques, proportion of abnormal cells and treatment regimens is needed. Based on data available today, bortezomib and carfilzomib treatment appear to improve complete response, progression-free survival and overall survival in t(4;14) and del(17/17p), while lenalidomide may be associated with improved progression-free survival in t(4;14) and del(17/17p). Patients with multiple adverse cytogenetic abnormalities do not benefit from these agents. FISH data are implemented in the revised International Staging System for risk stratification. |
X Demographics
Geographical breakdown
Country | Count | As % |
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United States | 12 | 29% |
Canada | 5 | 12% |
United Kingdom | 3 | 7% |
Spain | 2 | 5% |
Italy | 1 | 2% |
Denmark | 1 | 2% |
Unknown | 18 | 43% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 25 | 60% |
Practitioners (doctors, other healthcare professionals) | 8 | 19% |
Science communicators (journalists, bloggers, editors) | 5 | 12% |
Scientists | 4 | 10% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Denmark | 1 | <1% |
Peru | 1 | <1% |
Unknown | 569 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 82 | 14% |
Other | 76 | 13% |
Student > Master | 51 | 9% |
Student > Bachelor | 48 | 8% |
Student > Ph. D. Student | 45 | 8% |
Other | 136 | 24% |
Unknown | 133 | 23% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 238 | 42% |
Biochemistry, Genetics and Molecular Biology | 68 | 12% |
Pharmacology, Toxicology and Pharmaceutical Science | 28 | 5% |
Agricultural and Biological Sciences | 24 | 4% |
Unspecified | 17 | 3% |
Other | 50 | 9% |
Unknown | 146 | 26% |