TY - JOUR
T1 - Treatment of multiple myeloma with high-risk cytogenetics
T2 - A consensus of the International Myeloma Working Group
AU - Sonneveld, Pieter
AU - Avet-Loiseau, Hervé
AU - Lonial, Sagar
AU - Usmani, Saad
AU - Siegel, David
AU - Anderson, Kenneth C.
AU - Chng, Wee Joo
AU - Moreau, Philippe
AU - Attal, Michel
AU - Kyle, Robert A.
AU - Caers, Jo
AU - Hillengass, Jens
AU - Miguel, Jesús San
AU - Van De Donk, Niels W.C.J.
AU - Einsele, Hermann
AU - Bladé, Joan
AU - Durie, Brian G.M.
AU - Goldschmidt, Hartmut
AU - Mateos, María Victoria
AU - Palumbo, Antonio
AU - Orlowski, Robert
N1 - Publisher Copyright:
© 2016 by The American Society of Hematology.
PY - 2016/6/16
Y1 - 2016/6/16
N2 - The International Myeloma Working Group consensus updates the definition for high-risk (HR) multiple myeloma based on cytogenetics Several cytogenetic abnormalities such as t(4;14), del(17/17p), t(14;16), t(14;20), nonhyperdiploidy, 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 have shown promise for HR cytogenetic diseases, such as proteasome inhibition in combination with lenalidomide/pomalidomide, double autologousstemcell 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 into the effect of new drugs in patients with cytogenetic abnormalities. However, 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), whereas 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.
AB - The International Myeloma Working Group consensus updates the definition for high-risk (HR) multiple myeloma based on cytogenetics Several cytogenetic abnormalities such as t(4;14), del(17/17p), t(14;16), t(14;20), nonhyperdiploidy, 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 have shown promise for HR cytogenetic diseases, such as proteasome inhibition in combination with lenalidomide/pomalidomide, double autologousstemcell 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 into the effect of new drugs in patients with cytogenetic abnormalities. However, 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), whereas 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.
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U2 - 10.1182/blood-2016-01-631200
DO - 10.1182/blood-2016-01-631200
M3 - Review article
C2 - 27002115
AN - SCOPUS:84976329685
SN - 0006-4971
VL - 127
SP - 2955
EP - 2962
JO - Blood
JF - Blood
IS - 24
ER -