Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Feb 3;5(2):e528.
doi: 10.1097/HS9.0000000000000528. eCollection 2021 Feb.

Multiple Myeloma: EHA-ESMO Clinical Practice Guidelines for Diagnosis, Treatment and Follow-up

Affiliations

Multiple Myeloma: EHA-ESMO Clinical Practice Guidelines for Diagnosis, Treatment and Follow-up

Meletios A Dimopoulos et al. Hemasphere. .

Erratum in

No abstract available

PubMed Disclaimer

Conflict of interest statement

MAD reported consultancy and honoraria from Janssen, Celgene, Takeda, Amgen and Bristol Myers Squibb. PM reported honoraria from Celgene, Janssen, Takeda, Amgen and Abbvie. ET reported honoraria from Bristol Myers Squibb, Janssen, Celgene, Takeda, Genesis Pharma, Amgen, Sanofi and Novartis and research funding from Janssen, Amgen, Takeda, Sanofi and Genesis Pharma. MVM reported honoraria from lectures and boards from Janssen, Celgene, Amgen, Takeda, Abbvie, GlaxoSmithKline, Adaptive, Roche and Seattle Genetics. SZ reported participation in advisory boards for Takeda, Celgene, Janssen, Sanofi and Oncopeptides and research funding from Celgene, Janssen and Takeda. GC reported being a member of speaker bureau for Takeda, Bristol Myers Squibb, Celgene, Amgen, Sanofi and Janssen and has received research grants from Bristol Myers Squibb, Celgene and Takeda. MD reported honoraria from Abbvie, Adaptive Biotechnologies, Amgen, Bristol Myers Squibb, Celgene, Janssen, Karyopharm, Sanofi and Takeda and has received research funding from Bristol Myers Squibb, Celgene, Janssen and Takeda. RH reported consultant or advisory roles for Janssen, Amgen, Celgene, AbbVie, Bristol Myers Squibb, Novartis, PharmaMar and Takeda; honoraria from Janssen, Amgen, Celgene, Bristol Myers Squibb, PharmaMar and Takeda and has received research grants from Janssen, Amgen, Celgene, Bristol Myers Squibb, Novartis and Takeda. FS reported honoraria from Amgen, Celgene, Bristol Myers Squibb, Takeda, Abbvie, Janssen, Novartis, SkyliteDX, Oncopeptides, Sanofi, GlaxoSmithKline, Adaptive and Merck Sharp & Dohme. MC reported honoraria from Janssen, Celgene, Amgen, Bristol Myers Squibb, Takeda, AbbVie, Sanofi and Adaptive Biotechnologies and speaker’s bureau membership for Janssen and Celgene. HG reported grants from Amgen, Bristol Myers Squibb, Celgene, Chugai, Dietmar-Hopp-Foundation, Janssen, John Hopkins University and Sanofi; research support from Amgen, Bristol Myers Squibb, Celgene, Chugai, Janssen, Incyte, Molecular Partners, Merck Sharp & Dohme, Sanofi, Mundipharma, Takeda and Novartis; participation in advisory boards for Adaptive Biotechnology, Amgen, Bristol Myers Squibb, Celgene, Janssen, Sanofi, Takeda; honoraria from Academy2 GmbH & Co. KG, Amgen, ArtTempi, Bristol Myers Squibb, Celgene, Chop GmbH, Chugai, FomF GmbH, GlaxoSmithKline, GWT Forschung und Innovation Dresden, InVo Institut für Versorgungsforschung in der Onkologie GbR, Janssen, Kompetenznetz Maligne Lymphome (KML), MedConcept GmbH, Medical Communication GmbH, New Concept Oncology, Novartis, Omnia Med Deutschland, Sanofi. TF reported speaker and advisory roles for Janssen, Bristol Myers Squibb, Takeda, advisory role for Roche, Sanofi, Karyopharm and Oncopeptides and Speaker for Amgen. HE reported consulting and advisory roles for Bristol Myers Squibb, Celgene, Janssen, Amgen, Takeda, Sanofi and GlaxoSmithKline; research funding from Bristol Myers Squibb, Celgene, Janssen, Amgen, GlaxoSmithKline and Sanofi; honoraria from Bristol Myers Squibb, Celgene, Amgen, Takeda, Sanofi and GlaxoSmithKline. MB has received honoraria from Sanofi, Celgene, Amgen, Janssen, Novartis, Bristol Myers Squibb and AbbVie; has served on the advisory boards for Janssen and GlaxoSmithKline; has received research funding from Sanofi, Celgene, Amgen, Janssen, Novartis, Bristol Myers Squibb and Mundipharma. JS-M reported consultancy for Amgen, Bristol Myers Squibb, Celgene, Janssen, Merck Sharp & Dohme, Novartis, GlaxoSmithKline, Takeda, Sanofi and Roche. PS reported honoraria and advisory roles for Celgene, Janssen, Amgen, Takeda, Bristol Myers Squibb and Skyline and research funding from Celgene, Amgen, Janssen and Takeda. UM reported honoraria from Celgene, Janssen, Amgen, Takeda, AbbVie, Bristol Myers Squibb and Sanofi.

Figures

Figure 1.
Figure 1.
Recommendations for MM front-line therapy. ASCT = autologous stem cell transplantation; DaraRd = daratumumab/lenalidomide/dexamethasone; DaraVMP = daratumumab/bortezomib/melphalan/prednisone; DaraVTD = daratumumab/bortezomib/thalidomide/dexamethasone; MM = multiple myeloma; Rd = lenalidomide/dexamethasone; VCD = bortezomib/cyclophosphamide/dexamethasone; VMP = bortezomib/melphalan/prednisone; VRd = bortezomib/lenalidomide/dexamethasone; VTD = bortezomib/thalidomide/dexamethasone.
Figure 2.
Figure 2.
Second-line options for MM patients who received VRd and Dara-based front-line therapies. The 3 different flowcharts shown in this figure depict 3 different scenarios—depending on the first-line treatment given (from left to right): second-line options after VRd first-line treatment, second-line options after DaraRd first-line treatment, and second-line options after DaraVMP or DaraVTD first-line treatment. aPatients with t(11;14). bPatients who progress while on monthly daratumumab are considered as daratumumab-refractory. cAll recommendations for patients who receive front-line therapy with daratumumab-based therapies are based on panel consensus as there are no trials evaluating regimens in second-line therapy that include patients refractory or exposed to daratumumab. Dara = daratumumab; Elo = elotuzumab; Isa = isatuximab; Ixa = ixazomib; K = carfilzomib; Kd = carfilzomib/dexamethasone; MM = multiple myeloma; PomVd = pomalidomide/bortezomib/dexamethasone; Rd = lenalidomide/dexamethasone; S = selinexor; Vd = bortezomib/dexamethasone; VMP = bortezomib/melphalan/prednisone; VRd = bortezomib/lenalidomide/dexamethasone; Ven = venetoclax; VTD = bortezomib/thalidomide/dexamethasone.
Figure 3.
Figure 3.
Recommendations for MM patients who received a third or subsequent line of therapy. aOnly phase IB data are published for DaraPd. Publication of phase III data are expected in 2021. bFor patients with t(11;14). Dara = daratumumab; Elo = elotuzumab; IMiD = immunomodulatory drug; Isa = isatuximab; Kd = carfilzomib/dexamethasone; mAb = monoclonal antibody; MM = multiple myeloma; PCd = pomalidomide/cyclophosphamide/dexamethasone; Pd = pomalidomide/dexamethasone; PI = proteasome inhibitor; S = selinexor; Sd = selinexor/dexamethasone; Vd = bortezomib/dexamethasone; Ven = venetoclax.

References

    1. Usmani SZ, Hoering A, Cavo M, et al. . Clinical predictors of long-term survival in newly diagnosed transplant eligible multiple myeloma - an IMWG research project. Blood Cancer J. 2018; 8:123. - PMC - PubMed
    1. Moreau P, San Miguel J, Sonneveld P, et al. . Multiple myeloma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2017; 28suppl_4iv52–iv61 - PubMed
    1. Caers J, Garderet L, Kortüm KM, et al. . European Myeloma Network recommendations on tools for the diagnosis and monitoring of multiple myeloma: what to use and when. Haematologica. 2018; 103:1772–1784 - PMC - PubMed
    1. Kumar S, Paiva B, Anderson KC, et al. . International Myeloma Working Group consensus criteria for response and minimal residual disease assessment in multiple myeloma. Lancet Oncol. 2016; 17:e328–e346 - PubMed
    1. Alonso R, Cedena MT, Wong S, et al. . Prolonged lenalidomide maintenance therapy improves the depth of response in multiple myeloma. Blood Adv. 2020; 4:2163–2171 - PMC - PubMed