Treatment of Multiple Myeloma and Related Disorders

Due to major advances in understanding the biology and pathogenesis of the disease, the management of multiple myeloma is changing rapidly. New diagnostic and prognostic criteria have been introduced, and treatment options are multiplying with high-dose chemotherapy regimens, stem cell transplants, and the development of novel agents and immune-based strategies that target tumor cells directly. This book is aimed at the practitioner who is looking to put these advances into clinical context. It will serve as an up-to-date resource for treatment of myeloma and related disorders. Chapters are written by international authorities and contain color photos, diagrams, and algorithms outlining preferred treatment strategies. Relevant scientific information is integrated throughout, but the focus here is on providing practical therapeutic guidance for oncologists and hematologists caring for myeloma patients. The book covers all myeloma subtypes and related disorders, including amyloidosis, Waldenstrom macroglobulinemia, plasmacytoma, MGUS, and POEMS syndrome. Cover......Page 1 Half-title......Page 3 Title......Page 5 Copyright......Page 6 Contents......Page 7 Contributors......Page 9 Global Overview of MM Genetics......Page 13 t(11;14)(q13;q32) and CCND3 translocations......Page 15 Trisomies......Page 16 Progression Genetic Events......Page 17 NF-κB abnormalities......Page 18 Chromosome 1 abnormalities......Page 20 Clinical Implications of Genetic Subtypes......Page 21 Consensus clinical implications: high-risk disease......Page 22 Progression from MGUS to MM......Page 23 Minimal genetic testing......Page 24 References......Page 25 Initiating Genetic Events......Page 30 t(4;14)......Page 31 Mutation of NF-κB......Page 32 Summary......Page 33 Thalidomide and lenalidomide......Page 34 Summary......Page 35 References......Page 36 Initial Treatment of Patients Eligible for Transplantation......Page 38 Thalidomide-dexamethasone......Page 39 Bortezomib-based regimens......Page 43 Melphalan, prednisone......Page 44 Summary recommendations for initial therapy in transplant candidates......Page 45 References......Page 46 Conventional Therapy......Page 49 Corticosteroids......Page 51 Thalidomide......Page 52 Future Directions......Page 55 References......Page 56 Conventional chemotherapy......Page 58 Thalidomide......Page 59 Thalidomide with dexamethasone......Page 60 Lenalidomide with Dex......Page 62 Bortezomib alone or with Dex......Page 63 Bortezomib with conventional agents......Page 64 Bortezomib together with lenalidomide......Page 66 Bortezomib with perifosine......Page 67 Treatment Considerations for Specific Patient Populations......Page 68 Future Directions......Page 69 References......Page 70 Clinical Manifestations of Myeloma Bone Disease......Page 76 Evaluation of Bone Involvement in Myeloma......Page 77 Treatment of Myeloma Bone Disease......Page 79 Novel Therapies for Myeloma Bone Disease......Page 82 Vertebroplasty and Kyphoplasty for Myeloma Bone Disease......Page 84 References......Page 85 Treatment of specific complications of bone disease......Page 88 Incidence and pathogenesis of renal failure......Page 89 High-dose therapy/autologous stem cell transplantation......Page 90 Renal replacement with dialysis......Page 91 Incidence and pathogenesis......Page 92 Spinal cord compression......Page 93 Leptomeningeal involvement......Page 94 References......Page 95 ASCT versus conventional chemotherapy......Page 98 What are the Conclusions of these Studies Completed 10 Years Ago or More?......Page 99 Conditioning regimen......Page 100 Which patients benefit from autologous stem cell transplantation?......Page 101 Thalidomide-based regimens......Page 102 Lenalidomide-based regimens......Page 103 Maintenance therapy after ASCT......Page 105 Can novel agents replace ASCT in all patients?......Page 107 Conclusion......Page 108 References......Page 109 Introduction......Page 113 Ablative Allografts......Page 114 Nonablative Allogeneic Transplants......Page 115 Comparative Trials......Page 118 How do we Improve Allogeneic Transplants for MM?......Page 120 References......Page 121 Classification......Page 124 Classifying Amyloidosis......Page 126 Amyloid Syndromes......Page 128 Prognosis......Page 129 Assessing Response in Amyloidosis......Page 131 Alkylating agents......Page 132 IMIDs......Page 133 Indications for stem cell transplantation......Page 134 References......Page 137 Cytogenetic findings......Page 141 Clinical Features......Page 142 IgM-related neuropathy......Page 144 Tissue deposition......Page 145 Hematological abnormalities......Page 146 Other investigations......Page 147 Treatment of Waldenström Macroglobulinemia......Page 148 Alkylator-based therapy......Page 149 CD20-directed antibody therapy......Page 150 Combination therapies......Page 151 Proteasome inhibitor......Page 152 Thalidomide and lenalidomide......Page 153 High-dose therapy and stem cell transplantation......Page 154 Response Criteria in Waldenström Macroglobulinemia......Page 155 References......Page 156 Definitions......Page 162 Clinical Presentation, Laboratory, and Imaging......Page 163 Treatment......Page 167 The Role of Adjuvant Chemotherapy......Page 168 Prognostic Factors and Outcome......Page 169 Clinical Presentation......Page 170 Treatment......Page 172 References......Page 173 Laboratory Approach to MGUS......Page 176 Percentage detected clinically and duration......Page 177 Mayo Clinic referral population of 241 patients......Page 178 Angiogenesis......Page 181 Risk-stratification model for MGUS......Page 182 Differential Diagnosis......Page 183 Idiopathic Bence Jones proteinuria......Page 184 Leukemia......Page 185 POEMS syndrome (osteosclerotic myeloma)......Page 186 Smoldering Multiple Myeloma......Page 187 Risk factors for progression......Page 188 References......Page 190 Pathogenesis......Page 194 Clinical Features......Page 195 Laboratory Investigations......Page 197 Prognosis......Page 198 Therapy......Page 199 Conclusions......Page 202 References......Page 203 Index......Page 207

an Up-to-date Resource For Treatment Of Myeloma And Related Disorders.

doody Review Services

reviewer:seema Singhal, Md(northwestern University Feinberg School Of Medicine)
description:this Small Book Covers The Management Of Patients With Multiple Myeloma And Related Diseases. Other Than Elements Of Diagnosis And Risk-stratification, It Deals Only With Therapeutic Aspects.
purpose:it Is Meant To Serve As An Up-to-date Resource For The Treatment Of Plasma Cell Dyscrasias, Which Is Important As The Body Of Knowledge In This Field -- In Terms Of Original Articles And Books -- Has Increased Substantially. Bearing In Mind The Gestation Period Of A Book, It Is Not Unreasonable To Expect Parts To Be Somewhat Outdated By The Time One Is Published. By And Large, However, This One Does Meet The Stated Objectives.
audience:practicing Physicians Who Care For Patients With Hematologic Malignancies On A Regular Basis Are The Intended Audience. The Contributors Are Well-known Experts In The Field.
features:the Book Covers All Aspects Of The Management Of Myeloma Such As Induction Therapy, Salvage Therapy, Hematopoietic Stem Cell Transplantation, And Treatment Of Various Complications. The Information Is Delivered Succinctly, In An Easy-to-read Manner. However, More Illustrations And Tables Providing Exact Doses Of Commonly Used Regimens Would Have Enhanced The Value Of This Book For Practicing Physicians.
assessment:overall, This Is A Readable, Useful Book, And Unlike Most Books In This Field, A Small And Light One.

Diagnosis and genetic classification of multiple myeloma / Rafael Fonseca and P. Leif Bergsagel Staging and risk-stratification of multiple myeloma / Keith Stewart Treatment of newly diagnosed multiple myeloma / S. Vincent Rajkumar and Robert A. Kyle Maintenance therapy in multiple myeloma / Sagar Lonial and Jonathan L. Kaufman Treatment of relapsed and relapsed/refractory multiple myeloma / Marc S. Raab, Paul G. Richardson, and Kenneth C. Anderson Diagnosis and treatment of myeloma bone disease / G. David Roodman Treatment of myeloma related complications / Joan Bladé and Laura Rosiñol Autologous transplantation for multiple myeloma / J-L Harousseau Allogeneic stem cell transplantation for multiple myeloma / William I. Bensinger Immunoglobulin light chain amyloidosis (AL) / Morie A. Gertz and Suzanne R. Hayman Waldenstrom's macrogloblinemia/lymphoplasmacytic lymphoma / Steven P. Treon and Giampaolo Merlini Diagnosis, risk-stratification and management of solitary plasmacytoma / Meletios A. Dimopoulos and Efstathios Kastritis Monoclonal gammopathy of undetermined significance and smoldering multiple myeloma / Robert A. Kyle and S. Vincent Rajkumar Diagnosis and treatment of poems syndrome / Angela Dispenzieri.