The treatment and prognosis of multiple myeloma have completely changed over the past years with the advent of the new non-chemotherapeutic agents like imids and proteasome inhibitors followed by their second generations and other new drugs. Their side effects are completely different from those seen with standard chemotherapeutic treatment. Some are common, like peripheral neuropathy, blood count changes, venous thromboembolic events, fatigue, and others. These different toxicity profiles allow combinations and sequences of administration, trying to avoid cumulative toxicities and increasing the treatment combinations. In the first edition of this book there were only three but important drugs. Just a few years down the road in this second edition, our armamentarium has enlarged to additional imids and proteasome inhibitors, as well as completely new drugs, being monoclonal antibodies and HDAC inhibitors, and certainly more to come including immuno-oncology drugs. Over the next few years on some of the new drugs, now used in relapsed/refractory myeloma, data will become available also in induction and maintenance therapy. It is highly probable that the explosion of indications of immuno-oncology treatments will include also multiple myeloma. The transformation two decades ago of this lethal disease into a chronic disorder is being further improved and confirmed more and more.
KeywordsMyeloma Plasma cell dyscrasias Side effects Thalidomide Lenalidomide Pomalidomide Bortezomib Carfilzomib Ixazomib Daratumumab Elotuzumab
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