Multiples Myelom – Prognose, Therapie und neue Entwicklungen

Die Diagnostik und Therapie des multiplen Myeloms hat sich in den letzten 15 Jahren stetig verbessert. Ein besseres Verständnis der Pathophysiologie der Erkrankung, modernere diagnostische Methoden und nicht zuletzt eine Welle von neu zugelassenen Medikamenten haben dabei in den letzten Jahren zu einer kontinuierlichen Verlängerung des Überlebens der Patienten geführt. So ist das multiple Myelom heutzutage zwar immer noch eine nicht heilbare hämatologische Neoplasie, die Erkrankung hat sich jedoch zu einer chronischen Erkrankung entwickelt. Dies spiegelt sich insbesondere in der 10-Jahres-Überlebensrate wider, die im Zeitalter der konventionellen Chemotherapie unter 10 % lag und heute für Patienten, die mit Hochdosistherapie und autologer Blutstammzelltransplantation in Kombination mit neuen Substanzen behandelt werden, bei ungefähr 50 % liegt. Im Folgenden sollen diese neuen Entwicklungen kurz zusammengefasst werden.

Diagnostic procedures and treatment options for patients with multiple myeloma tremendously improved during the last 15 years. A more profound understanding of the pathophysiology of the disease in combination with more sensitive diagnostic methods and last but not least an abundant number of novel drugs resulted in a significantly prolongation of the overall survival of patients. As a consequence the diagnosis of multiple myeloma is no longer associated with a fatal prognosis with less than 10 % of patients surviving 10 years or more. Currently, half of the young and fit patients, who are treated with combination therapy including novel agents and high dose chemotherapy followed by autologous stem cell transplantation, are living longer than 10 years and multiple myeloma has become a chronic disease. This review summarizes the recent changes in the understanding, management and treatment of patients with multiple myeloma.

Key words

Multiple myeloma - high dose therapy - autologous stem cell transplantation - novel agents

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