The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

General Information

Updated statistics with estimated new cases and deaths for 2009 (cited American Cancer Society as reference 1).

Added text to include the median survival of 45 months to 60 months resulting from the improvements in prognosis found with newer therapies (cited Kumar et al. as reference 2, Ludwig et al. as reference 3, and Brenner et al. as reference 4).

Cellular Classification

Added Kyle et al. as reference 1.

Stage Information

Added Kyle et al. as reference 14.

Added text about the gradually rising level of monoclonal gammopathy of undetermined significance that precedes virtually all cases of multiple myeloma (cited Weiss et al. as reference 20, Landgren et al. as reference 21, and Bladé et al. as reference 22).

Multiple Myeloma

Added text about the helpfulness of quantitative serum-free light chains to follow response if an M protein is not apparent.

Added text about the unclear choice of induction therapies, which include the use of steroids, thalidomide, and lenalidomide.

Added text to state that there are several active agents used as induction therapy either alone or in combinations, but clinical trials are needed to establish regimens with the best efficacy and least long-term toxicity.

Added Rajkumar et al. as reference 20 and Palumbo et al. as reference 22 [Blood, 112, 2008].

Added Palumbo et al. as reference 29 [Blood, 111, 2008] and Niesvizky et al. as reference 34.

Added text about the proposed use of 81 mg of aspirin as deep venous thrombosis prophylaxis, but randomized clinical trials have not yet confirmed benefit.

Added text about a VISTA trial with patients who were not candidates for stem cell transplatation because of age that compared bortezomib combined with melphalan and prednisone versus melphalan and prednisone alone (cited San Miguel et al. as reference 37 and level of evidence 1iiA).

Added text to include statistics that support a study of patients with relapsing myeloma that compared intravenous bortezomib with high-dose oral dexamethasone (cited Richardson et al. as reference 38 and Argyriou et al. as reference 41).

Added text to state that because bortezomib is metabolized and cleared by the liver, it appears active and well tolerated in patients with renal impairment (cited San Miguel et al. as reference 47).

Added new subsection on Combination therapy.

Added Koreth et al. as reference 80 and Pineda-Roman et al. as reference 81.

Added text about three groups that compared two tandem autologous transplants versus one autologous transplant followed by a reduced-intensity conditioning allograft from an HLA-identical sibling, and the discordant results for survival in the nonrandomized trials (cited Moreau et al. as reference 89, Rosiñol et al. as reference 90, and level of evidence 3iiiA).

Added text about a trial with newly diagnosed myeloma patients that randomly compared two tandem transplants with a single autologous stem cell transplant followed by 6 months of maintenance therapy with thalidomide (cite Abdelkefi et al. as reference 91 and level of evidence1iiA).

Added text about a trial of patients who, after autologous transplantation, were randomly assigned to indefinite prednisone versus indefinite prednisone with 12 months of thalidomide (cited Spencer et al. as reference 114 and level of evidence 1iiA).

Monoclonal Gammopathy of Undetermined Significance

Added Kyle et al. as reference 1.

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