Biology and therapy of multiple myeloma

Summary

• Genetic sequencing of the myeloma genome has not revealed a specific disease‐determining genetic alteration.
• Multiple disease subclones exist at diagnosis and vary in clinical importance with time and drug sensitivity.
• New diagnostic criteria have identified indications for early introduction of therapy.
• Autologous stem cell transplantation remains an essential component of therapy in young and fit patients.
• The use of continual suppressive (maintenance) therapy has been established as an important component in therapy.
• Immune therapies and the harnessing of the innate immune system offer great promise for future treatments.
• Since 2005, quality of life, supportive therapies, and survival have dramatically improved over a decade of remarkable progress.
• The common manifestations of multiple myeloma, such as bone pain, fatigue and weight loss, may be non‐specific and are often initially ignored or missed by patients and medical practitioners.