Many progresses for the treatment of multiple myeloma have been made since last decade.The application of novel target agents has brought the treatment of multiple myeloma into a new era.The outcomes of multiple myeloma have also been greatly improved with mechanism-based combinations of various agents.It is emphasized that clinicians should better understand the biological characteristics of myeloma cells and the anti-myeloma mechanisms underlined.In this review,the author will review the current status and make a prospective discussion in this field.

In present study,we detected HLA-DR antigens on monocytes of 28 patients with mutiplemyelomas (MM) and 20 normal controls with indirect immunofluorescent staining and flow cy-tometric technique.It was descovered that HLA-DR~+ monocytes of patients (33.63?16.24%)were greatly lower than these of normal controls (61.45?10.1% ) (P

Hematopoietic Stem Cell Transplantation ; Humans ; Multiple Myeloma ; pathology ; therapy ; Neoplasm Staging ; Transplantation, Autologous

Diagnostic Imaging ; Humans ; Multiple Myeloma ; diagnosis ; therapy

Humans ; Multiple Myeloma ; Neoplasm Recurrence, Local

The treatment of multiple myeloma has become possible in the era of novel agents. Novel agents have dramatically improved the response rates of multiple myeloma (MM) and have extended the survival of patients even if MM remains an incurable disease. De-termining the treatment goals of MM has become a major challenge for clinicians in the era of novel agents. Many results show the correlation between response depth and patients' survival. Complete remission (CR), stringent CR, phenotypic CR, and CRs at the molecular and PET-CT levels are being explored and becoming the goals of MM treatment. Doctors should balance efficacy with adverse effects in daily clinical practice to avoid the blind pursuit of a high and deep response rate.

Autologous stem cell transplantation (ASCT) is the standard frontline therapy for newly diagnosed multiple myeloma (MM) in patients younger than 65 years in the era of conventional chemotherapy. The use of novel drug-based chemotherapy in the in-duction, consolidation, and maintenance phases of chemotherapy has significantly improved the response rates of patients. Thus, wheth-er or not ASCT is still necessary in the era of new drugs has become controversial. Currently available data supported that ASCT should be the frontline therapy for qualified newly diagnosed MM patients and that new drugs may be applied before and after ASCT to further improve the response rate and prolong the progression-free survival of patients. Further prospective clinical trials should be conducted to clarify the role of ASCT in MM and optimize the treatment strategies involving ASCT in the era of new drugsto cure myeiona.

Multiple myeloma (MM) is the second most common hematological malignancy.In the 56th American Society of Hematology (ASH) annual meeting,there are mainly five hot and key topics focusing on development of MM treatment,including when is the opportunity of transplant-eligible patients in the era of novel therapy? Should continuous therapy be the standard therapeutic approach in MM? What is a practical approach to relapsed MM? How should the recurrence/refractory MM patients be managed and treated? And what are the approved agents and novel agents?

According to the latest classification of International Myeloma Working Group(IMWG),multiple myeloma(MM)is roughly classified into two groups,asymptomatic myeloma(smoldering myeloma)and symptomatic myeloma.The former is equal to the stage Ⅰ of Durie-Salmon(DS),and patients of this type only wait and see,and do not need any therapy.The later is equal to stage Ⅱ and Ⅲ of DS,and patients of this type need therapy immediately.Autologous stem cell transplantation(ASCT)is recommended by National Comprehensive Cancer Network(NCCN)for patients with stage Ⅱ or Ⅲ myeloma with good performance status in 2007.Different therapeutic regiwen should he selected for newly diagnosed MM patients according to whether ASCT is suitable or not.

Multiple myeloma (MM) remains an incurable disease at present. In past decade, the efficacies of treatment and patients' survivals have been greatly improved due to the application of high dose chemotherapy followed by stem cell transplantation, novel agents and their combinations. To further improve the outcomes of patients with MM, we should emphasize on exploration of the new treatment strategies, individualization of regimens and development of new targets.