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Dtsch Med Wochenschr 2020; 145(12): 820-827
DOI: 10.1055/a-1016-0384
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Rezidivtherapie des Multiplen Myeloms – Individualisierte Konzepte aus dem Arsenal vielfältiger Optionen

Recurrent Therapy of Multiple Myeloma – Individualized Concepts from The Arsenal of Diverse Options
Charlotte Weyermann
,
Christian Straka
,
Hermann Einsele
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Abstract

The prognosis of patients with multiple myeloma has improved significantly over the past 20 years. However, the patient population in the relapse situation is very heterogeneous due to increasing age and the previous course of the disease and therapy. In particular, the approval of new targeted substances offers numerous treatment options that can be adapted to the individual situation.

In relapsed multiple myeloma, disease- and patient-specific factors must be considered for an individually adapted therapy. Suitable patients can also receive an autologous stem cell transplant (ASCT) or, in the case of early relapse after ASCT, an allogenic stem cell transplant, if possible as part clinical studies. Proteasome or immunomodulator-based triple combinations are the standard in recurrence. In frail patients, a combination of two can also be used. The new substances also offer very good therapeutic options for high-risk cytogenetics or renal insufficiency. The monoclonal antibodies Daratumumab and Elotuzumab are well tolerated except for infusion reactions and are highly effective in various combinations, even in high-risk cytogenetics.

Die Prognose von Patienten mit Multiplem Myelom hat sich in den letzten 20 Jahren deutlich verbessert. Das Patientenkollektiv in der Rezidivsituation ist jedoch aufgrund des zunehmenden Alters und des vorangegangenen Krankheits- und Therapieverlaufs sehr heterogen. Insbesondere durch die Zulassung neuer zielgerichteter Substanzen bieten sich zahlreiche Therapieoptionen, die an die individuelle Situation angepasst werden können.

Schlüsselwörter

Rückfall - patientenspezifische Faktoren - Hochrisiko-Zytogenetik - 3-fach-Kombinationen - monoklonale Antikörper

Key words

relapse - patient-specific factors - high-risk cytogenetics - triple combinations - monoclonal antibodies


Publication History

Article published online:
17 June 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 

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