Multiple myeloma is a plasma-cell neoplasm that is characterizedby skeletal destruction, renal failure, anemia, and hypercalcemia.1Although myeloma remains incurable, recent advances in its treatment,including the use of thalidomide and new drugs such as bortezomiband CC-5013, are promising.2
Diagnosis
The most common symptoms on presentation are fatigue, bone pain,and recurrent infections.3 New diagnostic criteria require thepresence of at least 10 percent plasma cells on examinationof the bone marrow (or biopsy of a tissue with monoclonal plasmacells), monoclonal protein in the serum or urine, and evidenceof end-organ damage.4,5 The end-organ damage that meets the. . . [Full Text of this Article]
Pathophysiology
Evolution of MGUS
Progression to Myeloma
Therapy
Induction Therapy in Patients Eligible for Autologous Stem-Cell Transplantation
Induction Therapy in Patients Not Eligible for Transplantation
Autologous Stem-Cell Transplantation
Tandem Transplantation
Allogeneic Transplantation
Maintenance Therapy
Therapy for Relapsed and Refractory Multiple Myeloma
Thalidomide
Clinical Trials
Adverse Effects
Dosage
Mechanism of Action
Bortezomib
Clinical Trials
Adverse Effects
Dosing
Mechanism of Action
CC-5013
Other Novel Agents
Treatment of Complications
Future Directions
Source Information
From the Division of Hematology and Internal Medicine, Mayo Clinic, Rochester, Minnesota.
Address reprint requests to Dr. Kyle at the Division of Hematology and Internal Medicine, Mayo Clinic, 200 First St. S.W., Rochester, MN 55905, or at kyle.robert@mayo.edu.
Related Letters:
Multiple Myeloma
Altundag K., Altundag O., Gundeslioglu O., Crawford C. L., Schneider H. G., Sentry J., Kyle R. A., Rajkumar S. V.
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N Engl J Med 2005;
352:840-841, Feb 24, 2005.
Correspondence
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A correction has been published: N Engl J Med 2005;352(11):1163.
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