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Evidence-based mini-review: treatment options for patients with relapsed/refractory myeloma previously treated with novel agents and high-dose chemotherapy and autologous stem-cell transplantation Shah N; Lonial SHematology Am Soc Hematol Educ Program 2010[]; 2010 (ä): 310-3A 64 year-old man with a history of multiple myeloma presents with new back pain. He has a history of International Staging System stage 1, IgG kappa multiple myeloma with normal cytogenetics which was diagnosed 4 years ago when he presented with a pathological fracture of the left humerus. He was initially managed with mechanical stabilization and 4 cycles of bortezomib-dexamethasone, as well as 2 years of bisphosphanates. Following induction therapy he achieved a very good partial response (VGPR). He subsequently received high-dose melphalan and autologous stem cell transplantation (auto-SCT) and achieved a complete reponse (CR) post-transplant. He did not receive maintenance therapy and had been lost-to follow-up for about a year. He now presents 5 years after initial diagnosis with back pain and is noted to have a new lytic lesion with a compression fracture at T8. A serum protein electrophoresis demonstrates reappearance of his original monoclonal protein. After appropriate stabilization he comes to you to discuss additional treatment options.|*Evidence-Based Medicine[MESH]|*Stem Cell Transplantation[MESH]|Antineoplastic Agents/*administration & dosage/*therapeutic use[MESH]|Dose-Response Relationship, Drug[MESH]|Humans[MESH]|Multiple Myeloma/*drug therapy[MESH]|Recurrence[MESH]|Transplantation, Autologous[MESH] |
