M. Delforge MD, PhD

Highlights in multiple myeloma

Summary

By tradition, multiple myeloma (MM) was again well represented in the different sessions during ASH 2019. This overview focusses on the most important clinical developments in MM that were presented at the last ASH meeting taking place early December in Orlando. We have selected the abstracts and presentations that we consider to be relevant for the Belgian healthcare system and for haematologists treating MM patients.

(BELG J HEMATOL 2020;11(1):9–12)

Anti-CD38 monoclonal antibodies in the treatment of multiple myeloma

SUMMARY

As the surface antigen CD38 is highly expressed on malignant plasma cells, it provides an interesting therapeutic target for the treatment of multiple myeloma (MM). At present, three anti-CD38 monoclonal antibodies (mAb) have been studied in MM: daratumumab, isatuximab and MOR202. All three anti-CD38 mAb show complement-dependent cytotoxicity (CDC), antibody-dependent cellular cytotoxicity (ADCC) and antibodydependent cellular phagocytosis (ADCP) activities. Moreover, immunomodulatory effects of daratumumab and isatuximab have been demonstrated. At present, daratumumab has been the most extensively studied anti-CD38 mAb in clinical trials. Following the excellent results of phase III clinical trials in relapsed/refractory MM (RRMM), daratumumab has recently also been studied in phase III clinical trials in newly diagnosed patients. The effects of isatuximab and MOR202 have been studied in phase III and phase I clinical trials, respectively, in patients with RRMM.

(BELG J HEMATOL 2019;10(8):326–31)

Highlights in multiple myeloma

SUMMARY

Over the last few years, the treatment landscape for patients with multiple myeloma (MM) changed dramatically. Also the 2019 annual meeting of the European Hematology Association featured several interesting MM abstracts. In this article we will discuss 6 highlights from the meeting. For a more complete overview of MM news at EHA 2019 we would like to refer to the congress website (https://ehaweb.org/congress/previous-congresses/eha24/abstracts-online-2/).

(BELG J HEMATOL 2019;10(5):203–7)

Practical management of newly-diagnosed multiple myeloma: 2018 update for transplant eligible patients

With the introduction of immunomodulatory agents and proteasome inhibitors, major improvements have been achieved in the treatment and outcome of multiple myeloma. Different treatment combinations are now in use and newer therapies are being developed. Nevertheless, autologous stem cell transplantation remains the corner stone of therapy for fit, newly-diagnosed multiple myeloma patients. Based on an extensive review of the recent literature, we propose recommendations on myeloma care, to be used by haematologists as a reference for daily practice.

(BELG J HEMATOL 2019;10(3):113–21)

Practical management of newly-diagnosed multiple myeloma: 2018 update for transplant eligible patients

SUMMARY

With the introduction of immunomodulatory agents (IMiDs) and proteasome inhibitors (PIs), major improvements have been achieved in the treatment and outcome of multiple myeloma (MM). Different treatment combinations are now in use and newer therapies are being developed. Nevertheless, autologous stem cell transplantation (ASCT) remains the corner stone of therapy for fit, newly-diagnosed MM patients. Based on an extensive review of the recent literature, we propose recommendations on myeloma care, to be used by haematologists as a reference for daily practice.

Management of relapsed and refractory multiple myeloma patients

SUMMARY

For the majority of multiple myeloma (MM) patients, their disease will behave as a chronic disorder with episodes of remission followed by disease progression. Whereas the treatment approach in frontline is rather uniform, treatment at relapse has become more heterogeneous, as therapeutic choices at this stage are driven by many factors including disease characteristics and patient status, but also the previous treatment(s), their therapeutic effect and toxicities, and drug availability. With each treatment course patients also tend to become more vulnerable to hematological and non-hematological toxicities. Therefore, particularly at later relapses where there is no standard of care, the benefits and potential risks of therapeutic decisions should be carefully balanced in each individual patient, to minimize excess toxicities. In this review article, an overview is provided of the currently available treatment options for patients with relapsed or refractory MM.

PP23 A simple frailty score to identify patients with malignant hemopathies who don’t benefit from standard dose chemotherapy