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[Multiple Myeloma - Current Status in Diagnostic Testing and Therapy].

Michael Kehrer1, Sebastian Koob1, Andreas Strauss1

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PubMed
Summary

Multiple myeloma diagnosis utilizes sensitive screening methods and imaging. Advanced therapies, including new agents and supportive care, are improving patient prognosis and survival rates.

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Area of Science:

  • Hematology
  • Oncology
  • Orthopedic Surgery

Background:

  • Multiple myeloma is a WHO-classified plasma cell neoplasm originating in the bone marrow.
  • Malignant transformation of plasma cells leads to abnormal immunoglobulin production (M protein), causing symptoms like bone damage and kidney issues.
  • It affects 6-7/100,000 worldwide, with approximately 6,000 new cases annually in Germany.

Purpose of the Study:

  • To review current diagnostic features and therapeutic strategies for multiple myeloma.
  • To highlight the importance of recognizing myeloma symptoms in clinical practice, particularly in orthopedics.
  • To evaluate the impact of novel therapeutic agents on patient outcomes.

Main Methods:

  • A comprehensive literature search was conducted on PubMed using keywords 'multiple myeloma,' 'diagnostic,' and 'therapy.'
  • Included were systematic reviews, meta-analyses, clinical studies, and international therapy recommendations published up to spring 2016.
  • The search focused on evaluating the current status of diagnosis and treatment.

Main Results:

  • Sensitive screening methods and a combination of physical evaluation, patient history, symptoms, and diagnostic tests (blood, urine, bone marrow biopsy, skeletal imaging) are crucial for diagnosis.
  • Diagnosis confirmation relies on major and minor criteria, classifying the disease as smoldering, symptomatic, or monoclonal gammopathy of undetermined significance (MGUS).
  • Treatment has advanced significantly, with high-dose chemotherapy and autologous stem cell transplantation as standard, alongside supportive therapies like bisphosphonates, radiation, and orthopedic surgery.

Conclusions:

  • Novel agents like immunomodulatory drugs, proteasome inhibitors, and antibodies show promise for improving multiple myeloma prognosis and survival.
  • Treatment algorithms are becoming more complex and costly.
  • Interdisciplinary cooperation and individualized, multimodal treatment plans are essential, especially considering supportive care for managing complications and side effects.