Biology and therapy of multiple myeloma

Med J Aust. 2019 May;210(8):375-380. doi: 10.5694/mja2.50129. Epub 2019 Apr 23.

Abstract

Genetic sequencing of the myeloma genome has not revealed a specific disease-determining genetic alteration. Multiple disease subclones exist at diagnosis and vary in clinical importance with time and drug sensitivity. New diagnostic criteria have identified indications for early introduction of therapy. Autologous stem cell transplantation remains an essential component of therapy in young and fit patients. The use of continual suppressive (maintenance) therapy has been established as an important component in therapy. Immune therapies and the harnessing of the innate immune system offer great promise for future treatments. Since 2005, quality of life, supportive therapies, and survival have dramatically improved over a decade of remarkable progress. The common manifestations of multiple myeloma, such as bone pain, fatigue and weight loss, may be non-specific and are often initially ignored or missed by patients and medical practitioners.

Keywords: Immunotherapies; Myeloma.

Publication types

  • Review

MeSH terms

  • Australia / epidemiology
  • Combined Modality Therapy
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Multiple Myeloma / diagnosis*
  • Multiple Myeloma / mortality*
  • Multiple Myeloma / therapy*
  • Quality of Life
  • Transplantation, Autologous