Controversies in Multiple Myeloma: A Theme Issue in Honor of Prof. Dr. Jesús San Miguel

A special issue of Hemato (ISSN 2673-6357). This special issue belongs to the section "Plasma Cell Disorders".

Deadline for manuscript submissions: closed (31 March 2024) | Viewed by 1235

Special Issue Editors


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Guest Editor
Clínica Universidad de Navarra, 31008 Pamplona, Spain
Interests: multiple myeloma; amyloidosis; Waldenström's Macroglobulinemia; acute myeloid leukemia; minimal residual disease; circulating tumor cells; flow cytometry

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Guest Editor
Department of Hematology, University Hospital Leuven, Leuven, Belgium
Interests: multiple myeloma; new drugs; adverse events; quality of life; drug resistance; AL amyloidosis

Special Issue Information

Dear Colleagues,

This Special Issue aims to honor Prof. Jesús San Miguel his outstanding scientific and clinical contributions in the field of multiple myeloma. His ability to integrate the clinic and the bench on a translational research model to serve patients was fueled since the beginning of his career by his mentor, Antonio López Borrasca. Since then, he has devoted his life to improving diagnosis, treatment and monitoring of patients with monoclonal gammopathies, and to train >40 Hematologists and >30 PhD students and instill in them his dream of curing hematological malignancies such as multiple myeloma. Prof. San Miguel is the author of nearly 1,000 manuscripts, and his contributions range from the i) leadership in pivotal studies that led to the approval of five therapies in multiple myeloma, ii) introducing the concept of early detection and intervention in smouldering myeloma and MRD states, iii) establishment of centralized cores for diagnosis and monitoring that have benefited >10,000 patients with hematological malignancies; iv) generating national and international cooperative groups and networks; and, v) passionate, committed service to the medical community and patients through the participation on domestic and international committees and commissions, as well as the generation of >20 guidelines and consensus documents on diagnosis, classification and treatment. One of Prof. San Miguel his unique personal features is that he cares profoundly about his colleagues and his main aim is to try to help others around him; that is why he is more than a myeloma expert, he is a respected personality and a friend for most of the members of the myeloma community.

This Special Issue covers several important but still controversial topics in the field of multiple myeloma including the management of high-risk smouldering myeloma, the role of prognostic and predictive factors of autologous stem cell transplantation. In addition, the increasing role of MRD, novel therapeutic agents like CAR-T and bispecific antibodies, the management of frail elderly patients and the road towards a cure in myeloma are discussed. The papers are written by world-leading experts in the field who are, last but not least, also good friends of Prof San Miguel.

Dr. Bruno Paiva
Prof. Dr. Michel Delforge
Guest Editors

Manuscript Submission Information

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Keywords

  • multiple myeloma
  • smouldering multiple myeloma
  • prognostic factors
  • autologous stem cell transplantation
  • minimal residual disease
  • frailty
  • CAR-T and bispecific antibodies
  • cure

Published Papers (2 papers)

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13 pages, 882 KiB  
Opinion
The Role of Autologous Stem Cell Transplantation in the Treatment of Newly Diagnosed Multiple Myeloma: Is It Time to Rethink the Paradigm in the Era of Targeted Therapy?
by Paul G. Richardson
Hemato 2024, 5(2), 144-156; https://doi.org/10.3390/hemato5020012 - 09 Apr 2024
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Abstract
High-dose melphalan (HDM) plus autologous stem cell transplant (ASCT) remains a standard-of-care treatment approach for eligible patients with newly diagnosed multiple myeloma (NDMM) based on demonstrated superiority in terms of progression-free survival (PFS) versus nontransplant approaches. Very high rates of minimal residual disease [...] Read more.
High-dose melphalan (HDM) plus autologous stem cell transplant (ASCT) remains a standard-of-care treatment approach for eligible patients with newly diagnosed multiple myeloma (NDMM) based on demonstrated superiority in terms of progression-free survival (PFS) versus nontransplant approaches. Very high rates of minimal residual disease (MRD)-negative responses are also being seen with novel triplet and quadruplet induction regimens plus HDM-ASCT. However, recent clinical trials have shown no overall survival benefit with transplant versus nontransplant approaches. Furthermore, HDM is associated with several important downsides, including acute and long-term toxicities, transient decreases in quality of life, the need for hospitalization, an increased mutational burden at relapse, and an elevated risk of second primary malignancies. In this context, given the highly heterogeneous nature of MM in the NDMM patient population, as well as the continued emergence of novel agents and treatment approaches, there is an increasing rationale for considering deferred HDM-ASCT approaches in selected patients. Approaches under investigation include MRD-adapted therapy and the use of novel immune-based therapies as alternatives to HDM-ASCT. Ongoing developments in understanding the pathobiology and prognostic factors in NDMM, plus immune profiling and routine MRD evaluation, will result in novel, HDM-sparing treatment paradigms, enabling further improvement in patient outcomes. Full article
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4 pages, 490 KiB  
Opinion
Elderly Patients with Newly Diagnosed Multiple Myeloma: Continuous or Fixed Duration Treatment?
by Salomon Manier and Thierry Facon
Hemato 2024, 5(2), 115-118; https://doi.org/10.3390/hemato5020010 - 01 Apr 2024
Viewed by 314
Abstract
Multiple myeloma (MM) presents unique challenges in the elderly population due to increased frailty and comorbidities. Balancing treatment efficacy, safety, and quality of life is essential in managing elderly patients. While two-drug regimens were often favored for elderly patients, recent studies show promising [...] Read more.
Multiple myeloma (MM) presents unique challenges in the elderly population due to increased frailty and comorbidities. Balancing treatment efficacy, safety, and quality of life is essential in managing elderly patients. While two-drug regimens were often favored for elderly patients, recent studies show promising outcomes with anti-CD38 antibody-based therapies, particularly daratumumab and lenalidomide with minimal dexamethasone. Continuous low-intensity treatments have shown improved progression-free survival and overall survival, with significant benefits observed in elderly patients. The DRd combination has now emerged as the standard of care for elderly MM patients, offering a favorable balance of efficacy, safety, and convenience. Ongoing trials are evaluating the addition of bortezomib in an induction phase for fit patients. New-generation immunotherapies hold promise for further refining treatment approaches, potentially leading to treatment discontinuation in select patient populations with sustained minimal residual disease negativity. Full article
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