Plasma Cell Neoplasms (Including Multiple Myeloma) Treatment (PDQ®)–Health Professional Version

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Changes to This Summary (11/04/2016)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

General Information About Plasma Cell Neoplasms

Added text to state that an increase in levels of serum-free light chain over many years can precede the clinical diagnosis of amyloid light-chain amyloidosis (cited Weiss et al. as reference 48).

Stage Information About Plasma Cell Neoplasms

Added text to state that the International Myeloma Working Group (IMWG) evaluated 4,445 patients to create a Revised International Staging System incorporating lactate dehydrogenase levels and interphase flourescence in situ hybridization results (cited Palumbo et al. as reference 2).

Revised statistics about criteria and median survival data in stages I, II, and III multiple myeloma in the International Staging System for Multiple Myeloma table.

Treatment Option Overview for Plasma Cell Neoplasms

Added text to the criteria about creatinine that was published by the IMWG to identify patients with active myeloma who require therapy, stating that myeloma can cause renal dysfunction via hypercalcemia, amyloidosis, or light chain deposition disease (cited Sayed et al. as reference 6).

Treatment for Amyloidosis Associated With Plasma Cell Neoplasms

Added text to state that between 2007 and 2012, the International Blood and Marrow Transplant Research Program identified 800 patients with amyloidosis who underwent autologous stem cell transplantation; the 5-year overall survival (OS) was 77% and transplant-related mortality was 5%, suggesting better selection of patients for transplantation (cited D'Souza et al. as reference 19 and level of evidence 3iiiA).

Treatment for Multiple Myeloma

Revised text to state that in fit patients, triple-drug regimens that include bortezomib are considered standard treatment in the absence of a clinical trial.

Added Moreau et al. as reference 71.

Added text about several phase I and phase II trials that evaluated the CD38 targeting monoclonal antibody daratumumab as a single agent for relapsed or refractory multiple myeloma (cited Usmani et al. as reference 72). Also revised statistics about median follow-up, overall response rate, and minimal response data.

Added Richardson et al. as reference 91.

Added text to state that triplets including either melphalan or cyclophosphamide combined with lenalidomide and dexamethasone were compared with a doublet of lenalidomide and dexamethasone in 662 patients; there were no differences in outcome for progression-free survival or OS, but the doublet showed less toxicity (cited Magarotto et al. as reference 96).

Added Palumbo et al. as reference 141.

Added Key References for Plasma Cell Neoplasms (Including Multiple Myeloma) as a new section.

This summary is written and maintained by the PDQ Adult Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ® - NCI's Comprehensive Cancer Database pages.

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