Treatment of Multiple Myeloma and Related Disorders

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