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
