Therapeutic options for extramedullary involvement in multiple myeloma

Area of Science:

• Hematology
• Oncology
• Immunology

Background:

• Extramedullary involvement (EMD) defines an aggressive subtype of multiple myeloma (MM).
• EMD is characterized by myeloma subclones outside the bone marrow, linked to high-risk genetics, immune evasion, and resistance to therapies.
• Despite advances in MM treatment, EMD significantly worsens patient prognosis and shows limited survival benefit even with immunotherapy.

Purpose of the Study:

• To systematically review and summarize current therapeutic strategies for multiple myeloma patients with extramedullary disease.
• To provide evidence-based guidance for clinicians managing EMD in multiple myeloma.

Main Methods:

• Systematic literature review of therapeutic options for MM with EMD.
• Analysis of treatment efficacy and outcomes based on published data.

Main Results:

• Recent MM therapies (proteasome inhibitors, immunomodulatory drugs, anti-CD38 antibodies) show limited impact on EMD survival.
• EMD patients continue to face poor prognosis despite advancements in MM treatment and immunotherapy.

Conclusions:

• Therapeutic options for EMD in multiple myeloma require further investigation and optimization.
• Evidence-based guidance is crucial for improving management and outcomes in EMD patients.