Onkológia 4/2013

Treatment of relapsed and refractory myeloma

The current treatment guidelines for relapsed and refractory myeloma recommend schemes with combination of 3 drugs: 1 or 2 of new drugs, corticosteroids and eventually a cytostatic agent. Monotherapy or two drugs combination are suggested for those, who are not fit for more intensive regimens. Use of bortezomib, lenalidomide and in very selected group of patients tandem ASCT followed by allogeneic stem cell transplantation can improve therapy results in diseaseas sociated with genetically defined ultra-high risk patients. ASCT should be used in patients with response duration long enough after first transplantation or it can be choice in a case of fulminant relapse. Relapse resistant to available treatment modalities can be managed with use of carfilozomib registrated in USA and pomalidomide recently registrated in EU.

Keywords: relapsed refractory myeloma, treatment, high-risk myeloma.