Chromosomal Abnormalities in Elderly With Multiple Myeloma
Chromosomal Abnormalities in Elderly With Multiple Myeloma
Nearly a quarter of MM patients are considered as high risk, depending on the genetic signature used. Although effective therapies targeting high-risk MM are currently not available, three important messages have emerged. First, clinical trials focused on high-risk MM are ongoing. Second, the stratification based on risk groups has allowed more personalized treatment for the standard-risk subgroup. Finally, the identification of high-risk markers is key for proper counseling of patients in a decision-making model. That is especially important in older patients, who have fewer therapeutic options available. Additional studies are required to examine the effectiveness of novel promising drugs, alone or in combination, such as carfilzomib and pomalidomide, among others. Finally, the lower incidence of deletion 13q14 and t(4;14) in very elderly patients compared with the remaining MM age groups leads to further discussion regarding the genetic heterogeneity and oncogenesis in different subgroups of MM patients. The popularization of the use of high-throughput tools for performing analysis at the genomic and transcriptomic level have opened up a unique opportunity to better dissect the genetic basis of MM in elderly patients.
Future Perspective
Nearly a quarter of MM patients are considered as high risk, depending on the genetic signature used. Although effective therapies targeting high-risk MM are currently not available, three important messages have emerged. First, clinical trials focused on high-risk MM are ongoing. Second, the stratification based on risk groups has allowed more personalized treatment for the standard-risk subgroup. Finally, the identification of high-risk markers is key for proper counseling of patients in a decision-making model. That is especially important in older patients, who have fewer therapeutic options available. Additional studies are required to examine the effectiveness of novel promising drugs, alone or in combination, such as carfilzomib and pomalidomide, among others. Finally, the lower incidence of deletion 13q14 and t(4;14) in very elderly patients compared with the remaining MM age groups leads to further discussion regarding the genetic heterogeneity and oncogenesis in different subgroups of MM patients. The popularization of the use of high-throughput tools for performing analysis at the genomic and transcriptomic level have opened up a unique opportunity to better dissect the genetic basis of MM in elderly patients.