Management of older adults with multiple myeloma.

摘要: For many years, the oral combination melphalan-prednisone (MP) has been considered standard of care for patients with multiple myeloma (MM) not eligible autologous stem cell transplantation. In era novel agents, introduction immunomodulatory drugs and proteasome inhibitors challenged role MP led to new standards this disease. Five randomized phase III studies compared traditional plus thalidomide (MPT). All these showed a prolonged time progression (TTP) 3-drug combination. However, in only two trials advantage translated into an improvement overall survival (OS). another trial, bortezomib (VMP) was correlated increase both TTP OS MP. Preliminary data superiority association VMP followed by bortezomib-thalidomide maintenance (VMPT-VT) vs melphalan-prednisone-lenalidomide lenalidomide (MPR-R) Promising results have also reported low-dose dexamethasone. The availability different efficacious regimens provided clinicians opportunity tailoring proper specific approach each patient. choice should be based on patients' comorbidities biologic age, while taking account expected toxicity profiles treatment regimen. Moreover, accurate management therapy-related adverse events gentler approach, particularly older than 75 appropriate age-adjusted dose reductions, further improve outcome.