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Epidemiology, Staging, and Management of Multiple Myeloma

1
Department of Medicine, Division of Nephrology, Hypertension and Transplant, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
2
Sidney Kimmel Cancer Center, Jefferson University, Philadelphia, PA 19107, USA
3
Hematology-Oncology, Allegheny Health Network, Pittsburgh, PA 15212, USA
4
Department of Internal Medicine, Sovah Health, Martinsville, VA 24112, USA
5
Department of Medicine, Hematology-Oncology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
6
Department of Medicine, Pathology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
*
Author to whom correspondence should be addressed.
Received: 24 July 2020 / Revised: 13 January 2021 / Accepted: 15 January 2021 / Published: 20 January 2021
(This article belongs to the Section Cancer and Cancer-Related Research)
Multiple myeloma (MM) is a plasma cell disorder that is on the rise throughout the world, especially in the US, Australia, and Western Europe. In the US, MM accounts for almost 2% of cancer diagnoses and over 2% of cancer deaths (more than double the global proportion). Incidence has risen by 126% globally and over 40% in the US since 1990, while global mortality has risen by 94% and US mortality has fallen by 18%. The 5 year survival in the US has more than doubled over the past decades with the introduction of new targeted therapies and transplant techniques. Risk factors for MM include age (average age of diagnosis is 69), race (African Americans are over double as likely to be diagnosed), sex (men are at a 1.5× risk), and family history. Diagnosis includes serum or urine electrophoresis and free light-chain assay but requires bone marrow biopsy. It is distinguished from smoldering myeloma and monoclonal gammopathy of undetermined significance by a high (>3 g/dL) level of M-protein (monoclonal light chains) and the presence of CRAB (Hypercalcemia, Renal failure, Anemia, Bone pain) symptoms, which include hypercalcemia, renal failure, anemia, and bone pain, suggesting an end-organ damage. International staging system staging involves beta 2 microglobulin and albumin levels, while the revised system considers prognostic factors such as lactate dehydrogenase levels and chromosomal abnormalities. Front-line management includes induction regimen, maintenance therapy and hematopoietic cell transplantation for eligible patients and bisphosphonates or bone-stimulating agents for the prevention of skeletal events. Treatment for relapsed disease includes newly approved monoclonal antibodies like the CD38-targeting daratumumab, proteasome inhibitors, immunomodulating agents, and investigational therapies such as B cell maturation antigen Chimeric antigen receptor T cells. View Full-Text
Keywords: multiple myeloma; epidemiology; etiology; risk factors; incidence; mortality; diagnosis; staging; treatment multiple myeloma; epidemiology; etiology; risk factors; incidence; mortality; diagnosis; staging; treatment
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MDPI and ACS Style

Padala, S.A.; Barsouk, A.; Barsouk, A.; Rawla, P.; Vakiti, A.; Kolhe, R.; Kota, V.; Ajebo, G.H. Epidemiology, Staging, and Management of Multiple Myeloma. Med. Sci. 2021, 9, 3. https://0-doi-org.brum.beds.ac.uk/10.3390/medsci9010003

AMA Style

Padala SA, Barsouk A, Barsouk A, Rawla P, Vakiti A, Kolhe R, Kota V, Ajebo GH. Epidemiology, Staging, and Management of Multiple Myeloma. Medical Sciences. 2021; 9(1):3. https://0-doi-org.brum.beds.ac.uk/10.3390/medsci9010003

Chicago/Turabian Style

Padala, Sandeep A., Adam Barsouk, Alexander Barsouk, Prashanth Rawla, Anusha Vakiti, Ravindra Kolhe, Vamsi Kota, and Germame H. Ajebo 2021. "Epidemiology, Staging, and Management of Multiple Myeloma" Medical Sciences 9, no. 1: 3. https://0-doi-org.brum.beds.ac.uk/10.3390/medsci9010003

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