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International Myeloma Working Group Consensus Statement for the Management, Treatment, and Supportive Care of Patients With Myeloma Not Eligible for Standard Autologous Stem-Cell Transplantation

Identifieur interne : 004090 ( Main/Exploration ); précédent : 004089; suivant : 004091

International Myeloma Working Group Consensus Statement for the Management, Treatment, and Supportive Care of Patients With Myeloma Not Eligible for Standard Autologous Stem-Cell Transplantation

Auteurs : Antonio Palumbo [Italie] ; S. Vincent Rajkumar [États-Unis] ; Jesus F. San Miguel [Espagne] ; Alessandra Larocca [Italie] ; Ruben Niesvizky [États-Unis] ; Gareth Morgan [Royaume-Uni] ; Ola Landgren [États-Unis] ; Roman Hajek [République tchèque] ; Hermann Einsele [Allemagne] ; Kenneth C. Anderson [États-Unis] ; Meletios A. Dimopoulos [Grèce] ; Paul G. Richardson [États-Unis] ; Michele Cavo [Italie] ; Andrew Spencer [Australie] ; A. Keith Stewart [États-Unis] ; Kazuyuki Shimizu [Japon] ; Sagar Lonial [États-Unis] ; Pieter Sonneveld [Pays-Bas] ; Brian G. M. Durie [États-Unis] ; Philippe Moreau [France] ; Robert Z. Orlowski [États-Unis]

Source :

RBID : Pascal:14-0114004

Descripteurs français

English descriptors

Abstract

Purpose To provide an update on recent advances in the management of patients with multiple myeloma who are not eligible for autologous stem-cell transplantation. Methods A comprehensive review of the literature on diagnostic criteria is provided, and treatment options and management of adverse events are summarized. Results Patients with symptomatic disease and organ damage (ie, hypercalcemia, renal failure, anemia, or bone lesions) require immediate treatment. The International Staging System and chromosomal abnormalities identify high- and standard-risk patients. Proteasome inhibitors, immunomodulatory drugs, corticosteroids, and alkylating agents are the most active agents. The presence of concomitant diseases, frailty, or disability should be assessed and, if present, treated with reduced-dose approaches. Bone disease, renal damage, hematologic toxicities, infections, thromboembolism, and peripheral neuropathy are the most frequent disabling events requiring prompt and active supportive care. Conclusion These recommendations will help clinicians ensure the most appropriate care for patients with myeloma in everyday clinical practice.

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<name sortKey="Dimopoulos, Meletios A" sort="Dimopoulos, Meletios A" uniqKey="Dimopoulos M" first="Meletios A." last="Dimopoulos">Meletios A. Dimopoulos</name>
<affiliation wicri:level="3">
<inist:fA14 i1="11">
<s1>University of Athens School of Medicine</s1>
<s2>Athens</s2>
<s3>GRC</s3>
<sZ>11 aut.</sZ>
</inist:fA14>
<country>Grèce</country>
<placeName>
<settlement type="city">Athènes</settlement>
<region nuts="2" type="region">Attique (région)</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Richardson, Paul G" sort="Richardson, Paul G" uniqKey="Richardson P" first="Paul G." last="Richardson">Paul G. Richardson</name>
<affiliation wicri:level="1">
<inist:fA14 i1="10">
<s1>Dana-Farber Cancer Institute</s1>
<s2>Boston, MA</s2>
<s3>USA</s3>
<sZ>10 aut.</sZ>
<sZ>12 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Dana-Farber Cancer Institute</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Cavo, Michele" sort="Cavo, Michele" uniqKey="Cavo M" first="Michele" last="Cavo">Michele Cavo</name>
<affiliation wicri:level="1">
<inist:fA14 i1="02">
<s1>Seragnoli Institute of Hematology, Bologna University School of Medicine</s1>
<s2>Bologna</s2>
<s3>ITA</s3>
<sZ>13 aut.</sZ>
</inist:fA14>
<country>Italie</country>
<wicri:noRegion>Bologna</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Spencer, Andrew" sort="Spencer, Andrew" uniqKey="Spencer A" first="Andrew" last="Spencer">Andrew Spencer</name>
<affiliation wicri:level="1">
<inist:fA14 i1="12">
<s1>Alfred Hospital</s1>
<s2>Melbourne, Victoria</s2>
<s3>AUS</s3>
<sZ>14 aut.</sZ>
</inist:fA14>
<country>Australie</country>
<wicri:noRegion>Alfred Hospital</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Keith Stewart, A" sort="Keith Stewart, A" uniqKey="Keith Stewart A" first="A." last="Keith Stewart">A. Keith Stewart</name>
<affiliation wicri:level="1">
<inist:fA14 i1="13">
<s1>Mayo Clinic</s1>
<s2>Scottsdale, AZ</s2>
<s3>USA</s3>
<sZ>15 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Mayo Clinic</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Shimizu, Kazuyuki" sort="Shimizu, Kazuyuki" uniqKey="Shimizu K" first="Kazuyuki" last="Shimizu">Kazuyuki Shimizu</name>
<affiliation wicri:level="1">
<inist:fA14 i1="14">
<s1>Aichi Gakuin Hospital</s1>
<s2>Nagoya</s2>
<s3>JPN</s3>
<sZ>16 aut.</sZ>
</inist:fA14>
<country>Japon</country>
<wicri:noRegion>Aichi Gakuin Hospital</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Lonial, Sagar" sort="Lonial, Sagar" uniqKey="Lonial S" first="Sagar" last="Lonial">Sagar Lonial</name>
<affiliation wicri:level="1">
<inist:fA14 i1="15">
<s1>Emory University</s1>
<s2>Atlanta, GA</s2>
<s3>USA</s3>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Emory University</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Sonneveld, Pieter" sort="Sonneveld, Pieter" uniqKey="Sonneveld P" first="Pieter" last="Sonneveld">Pieter Sonneveld</name>
<affiliation wicri:level="3">
<inist:fA14 i1="16">
<s1>Erasmus Medical Centre</s1>
<s2>Rotterdam</s2>
<s3>NLD</s3>
<sZ>18 aut.</sZ>
</inist:fA14>
<country>Pays-Bas</country>
<placeName>
<settlement type="city">Rotterdam</settlement>
<region nuts="2" type="province">Hollande-Méridionale</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Durie, Brian G M" sort="Durie, Brian G M" uniqKey="Durie B" first="Brian G. M." last="Durie">Brian G. M. Durie</name>
<affiliation wicri:level="1">
<inist:fA14 i1="17">
<s1>Cedars-Sinai Comprehensive Cancer Center</s1>
<s2>Los Angeles, CA</s2>
<s3>USA</s3>
<sZ>19 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Cedars-Sinai Comprehensive Cancer Center</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Moreau, Philippe" sort="Moreau, Philippe" uniqKey="Moreau P" first="Philippe" last="Moreau">Philippe Moreau</name>
<affiliation wicri:level="3">
<inist:fA14 i1="18">
<s1>University Hospital</s1>
<s2>Nantes</s2>
<s3>FRA</s3>
<sZ>20 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName>
<region type="region">Pays de la Loire</region>
<region type="old region">Pays de la Loire</region>
<settlement type="city">Nantes</settlement>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Orlowski, Robert Z" sort="Orlowski, Robert Z" uniqKey="Orlowski R" first="Robert Z." last="Orlowski">Robert Z. Orlowski</name>
<affiliation wicri:level="1">
<inist:fA14 i1="19">
<s1>MD Anderson Cancer Center</s1>
<s2>Houston, TX</s2>
<s3>USA</s3>
<sZ>21 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>MD Anderson Cancer Center</wicri:noRegion>
</affiliation>
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</analytic>
<series>
<title level="j" type="main">Journal of clinical oncology</title>
<title level="j" type="abbreviated">J. clin. oncol.</title>
<idno type="ISSN">0732-183X</idno>
<imprint>
<date when="2014">2014</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt>
<title level="j" type="main">Journal of clinical oncology</title>
<title level="j" type="abbreviated">J. clin. oncol.</title>
<idno type="ISSN">0732-183X</idno>
</seriesStmt>
</fileDesc>
<profileDesc>
<textClass>
<keywords scheme="KwdEn" xml:lang="en">
<term>Autologous hematopoietic stem cell transplantation</term>
<term>B cell neoplasm</term>
<term>Cancerology</term>
<term>Clinical management</term>
<term>Consensus</term>
<term>Hematopoietic Stem Cell Transplantation</term>
<term>Hematopoietic cell</term>
<term>Human</term>
<term>Humans</term>
<term>International</term>
<term>Lymphoid neoplasm</term>
<term>Multiple Myeloma (diagnosis)</term>
<term>Multiple Myeloma (therapy)</term>
<term>Myeloma</term>
<term>Palliative Care</term>
<term>Prognosis</term>
<term>Standards</term>
<term>Stem cell</term>
<term>Supportive care</term>
<term>Treatment</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr">
<term>Humains</term>
<term>Myélome multiple ()</term>
<term>Myélome multiple (diagnostic)</term>
<term>Pronostic</term>
<term>Soins palliatifs</term>
<term>Transplantation de cellules souches hématopoïétiques</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en">
<term>Multiple Myeloma</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr">
<term>Myélome multiple</term>
</keywords>
<keywords scheme="MESH" qualifier="therapy" xml:lang="en">
<term>Multiple Myeloma</term>
</keywords>
<keywords scheme="MESH" xml:lang="en">
<term>Hematopoietic Stem Cell Transplantation</term>
<term>Humans</term>
<term>Palliative Care</term>
<term>Prognosis</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr">
<term>Humains</term>
<term>Myélome</term>
<term>International</term>
<term>Consensus</term>
<term>Conduite à tenir</term>
<term>Myélome multiple</term>
<term>Pronostic</term>
<term>Soins palliatifs</term>
<term>Traitement</term>
<term>Soin de support</term>
<term>Homme</term>
<term>Norme</term>
<term>Cellule hématopoïétique</term>
<term>Cellule souche</term>
<term>Cancérologie</term>
<term>Hémopathie maligne lymphoïde</term>
<term>Hémopathie lymphoïde B</term>
<term>Autogreffe de cellules souches hématopoïétiques</term>
<term>Transplantation de cellules souches hématopoïétiques</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr">
<term>Homme</term>
<term>Norme</term>
<term>Cellule souche</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">Purpose To provide an update on recent advances in the management of patients with multiple myeloma who are not eligible for autologous stem-cell transplantation. Methods A comprehensive review of the literature on diagnostic criteria is provided, and treatment options and management of adverse events are summarized. Results Patients with symptomatic disease and organ damage (ie, hypercalcemia, renal failure, anemia, or bone lesions) require immediate treatment. The International Staging System and chromosomal abnormalities identify high- and standard-risk patients. Proteasome inhibitors, immunomodulatory drugs, corticosteroids, and alkylating agents are the most active agents. The presence of concomitant diseases, frailty, or disability should be assessed and, if present, treated with reduced-dose approaches. Bone disease, renal damage, hematologic toxicities, infections, thromboembolism, and peripheral neuropathy are the most frequent disabling events requiring prompt and active supportive care. Conclusion These recommendations will help clinicians ensure the most appropriate care for patients with myeloma in everyday clinical practice.</div>
</front>
</TEI>
<affiliations>
<list>
<country>
<li>Allemagne</li>
<li>Australie</li>
<li>Espagne</li>
<li>France</li>
<li>Grèce</li>
<li>Italie</li>
<li>Japon</li>
<li>Pays-Bas</li>
<li>Royaume-Uni</li>
<li>République tchèque</li>
<li>États-Unis</li>
</country>
<region>
<li>Angleterre</li>
<li>Attique (région)</li>
<li>Grand Londres</li>
<li>Hollande-Méridionale</li>
<li>Pays de la Loire</li>
<li>Piémont</li>
</region>
<settlement>
<li>Athènes</li>
<li>Londres</li>
<li>Nantes</li>
<li>Rotterdam</li>
<li>Turin</li>
</settlement>
</list>
<tree>
<country name="Italie">
<region name="Piémont">
<name sortKey="Palumbo, Antonio" sort="Palumbo, Antonio" uniqKey="Palumbo A" first="Antonio" last="Palumbo">Antonio Palumbo</name>
</region>
<name sortKey="Cavo, Michele" sort="Cavo, Michele" uniqKey="Cavo M" first="Michele" last="Cavo">Michele Cavo</name>
<name sortKey="Larocca, Alessandra" sort="Larocca, Alessandra" uniqKey="Larocca A" first="Alessandra" last="Larocca">Alessandra Larocca</name>
</country>
<country name="États-Unis">
<noRegion>
<name sortKey="Vincent Rajkumar, S" sort="Vincent Rajkumar, S" uniqKey="Vincent Rajkumar S" first="S." last="Vincent Rajkumar">S. Vincent Rajkumar</name>
</noRegion>
<name sortKey="Anderson, Kenneth C" sort="Anderson, Kenneth C" uniqKey="Anderson K" first="Kenneth C." last="Anderson">Kenneth C. Anderson</name>
<name sortKey="Durie, Brian G M" sort="Durie, Brian G M" uniqKey="Durie B" first="Brian G. M." last="Durie">Brian G. M. Durie</name>
<name sortKey="Keith Stewart, A" sort="Keith Stewart, A" uniqKey="Keith Stewart A" first="A." last="Keith Stewart">A. Keith Stewart</name>
<name sortKey="Landgren, Ola" sort="Landgren, Ola" uniqKey="Landgren O" first="Ola" last="Landgren">Ola Landgren</name>
<name sortKey="Lonial, Sagar" sort="Lonial, Sagar" uniqKey="Lonial S" first="Sagar" last="Lonial">Sagar Lonial</name>
<name sortKey="Niesvizky, Ruben" sort="Niesvizky, Ruben" uniqKey="Niesvizky R" first="Ruben" last="Niesvizky">Ruben Niesvizky</name>
<name sortKey="Orlowski, Robert Z" sort="Orlowski, Robert Z" uniqKey="Orlowski R" first="Robert Z." last="Orlowski">Robert Z. Orlowski</name>
<name sortKey="Richardson, Paul G" sort="Richardson, Paul G" uniqKey="Richardson P" first="Paul G." last="Richardson">Paul G. Richardson</name>
</country>
<country name="Espagne">
<noRegion>
<name sortKey="San Miguel, Jesus F" sort="San Miguel, Jesus F" uniqKey="San Miguel J" first="Jesus F." last="San Miguel">Jesus F. San Miguel</name>
</noRegion>
</country>
<country name="Royaume-Uni">
<region name="Angleterre">
<name sortKey="Morgan, Gareth" sort="Morgan, Gareth" uniqKey="Morgan G" first="Gareth" last="Morgan">Gareth Morgan</name>
</region>
</country>
<country name="République tchèque">
<noRegion>
<name sortKey="Hajek, Roman" sort="Hajek, Roman" uniqKey="Hajek R" first="Roman" last="Hajek">Roman Hajek</name>
</noRegion>
</country>
<country name="Allemagne">
<noRegion>
<name sortKey="Einsele, Hermann" sort="Einsele, Hermann" uniqKey="Einsele H" first="Hermann" last="Einsele">Hermann Einsele</name>
</noRegion>
</country>
<country name="Grèce">
<region name="Attique (région)">
<name sortKey="Dimopoulos, Meletios A" sort="Dimopoulos, Meletios A" uniqKey="Dimopoulos M" first="Meletios A." last="Dimopoulos">Meletios A. Dimopoulos</name>
</region>
</country>
<country name="Australie">
<noRegion>
<name sortKey="Spencer, Andrew" sort="Spencer, Andrew" uniqKey="Spencer A" first="Andrew" last="Spencer">Andrew Spencer</name>
</noRegion>
</country>
<country name="Japon">
<noRegion>
<name sortKey="Shimizu, Kazuyuki" sort="Shimizu, Kazuyuki" uniqKey="Shimizu K" first="Kazuyuki" last="Shimizu">Kazuyuki Shimizu</name>
</noRegion>
</country>
<country name="Pays-Bas">
<region name="Hollande-Méridionale">
<name sortKey="Sonneveld, Pieter" sort="Sonneveld, Pieter" uniqKey="Sonneveld P" first="Pieter" last="Sonneveld">Pieter Sonneveld</name>
</region>
</country>
<country name="France">
<region name="Pays de la Loire">
<name sortKey="Moreau, Philippe" sort="Moreau, Philippe" uniqKey="Moreau P" first="Philippe" last="Moreau">Philippe Moreau</name>
</region>
</country>
</tree>
</affiliations>
</record>

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