Is it time for preemptive drug treatment of asymptomatic (smoldering) multiple myeloma?
Asymptomatic (smoldering) multiple myeloma is a heterogeneous plasma cell proliferative disorder with a variable rate of progression to active multiple myeloma or related disorders. Hypercalcemia, renal insufficiency, anemia, bone lesions or recurrent bacterial infections characterize active multiple myeloma. Some patients with asymptomatic myeloma develop active disease rapidly, and others can stay asymptomatic for many years. Those who are likely to progress within the first 2 years of diagnosis have been categorized as having high-risk disease. The availability of novel agents in the treatment of active multiple myeloma and our better understanding of the heterogeneity of asymptomatic multiple myeloma have spurred interest in the early treatment of these patients. We have reviewed the current proposed definitions of high-risk asymptomatic multiple myeloma, the concerns about future therapy in view of the transient nature, remissions and toxicities of the therapies, and the eventual relapses that characterize this incurable disease.
['Fawole|Adewale|A|', 'Abonour|Rafat|R|', 'Stender|Michael|M|', 'Shatavi|Seerin|S|', 'Gaikazian|Susanna|S|', 'Anderson|Joseph|J|', 'Jaiyesimi|Ishmael|I|']
D000970:Antineoplastic Agents D058070:Asymptomatic Diseases D002986:Clinical Trials as Topic D060965:Clonal Evolution D018450:Disease Progression D019008:Drug Resistance, Neoplasm D006801:Humans D009101:Multiple Myeloma D016896:Treatment Outcome
Myeloma chemotherapeutic approaches cytogenetics