Version May 2024
In MM, we define resource-limited settings as those areas with limited access to thalidomide analogs, proteasome inhibitors, monoclonal antibodies, and other novel agents. There is no standard of care and different experts use different regimens.
In addition to therapy directed at the malignant clone, the management of most patients with MM includes preventative measures to reduce the incidence of skeletal events, kidney damage, infections, and thrombosis.MM: multiple myeloma; HCT: hematopoietic cell transplantation; VCd: bortezomib, cyclophosphamide, and dexamethasone; VTd: bortezomib, thalidomide, and dexamethasone; CTd: cyclophosphamide, thalidomide, and dexamethasone; MPT: melphalan, prednisone, and thalidomide; VRd: bortezomib, lenalidomide, dexamethasone.
* The number of cycles used depends on how quickly logistical arrangements can be made to proceed with stem cell collection and HCT.
¶ If the patient has access to lenalidomide, VRd is preferred instead of VCd or VTd. Those who undergo HCT are offered post-HCT lenalidomide maintenance. Those who do not undergo HCT are offered 8 to 12 cycles of VRd followed by lenalidomide maintenance.
Δ While thalidomide maintenance prolongs remission, use is limited by toxicity, especially neurotoxicity.
◊ The number of cycles used depends on how well they tolerate the regimen and the response to treatment. If the disease continues to respond and the patient is tolerating therapy, we will offer up to 12 cycles of initial therapy.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
