Introduction to relapsed and refractory multiple myeloma

摘要

Multiple myeloma is a malignancy of clonal plasma cells. It is characterized by destructive bone lesions, hyperglycemia, renal failure, and the presence of paraproteinemia, as well as hematologic dysfunction. It is the second most common hematologic malignancy and is more frequent in individuals in the seventh or eighth decade of life.1'2 With conventional therapy, the median survival has been approximately 3 years, but with the advent of novel agents, the survival has significantly improved. Relapsed myeloma refers to a clinical scenario in which a patient who has been treated to a maximum response experiences progression of disease. Refractory myeloma refers to a clinical scenario in which the patient is not responsive to the current therapy or progresses within 2 months of the last treatment. Patients who fail to achieve any response whatsoever and then progress on therapy are especially challenging and fall into the category of primary refractory myeloma. Relapsed and refractory myeloma describes a patient who previously achieved a response, experienced progression of disease, received salvage therapy, and is either unresponsive to the salvage therapy proposed or progresses within 60 days of treatment.