Jeffrey Wolf, MD, clinical professor, Department of Medicine, director, Myeloma Program, University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, discusses high-risk multiple myeloma.
The origin of the name multiple myeloma came from the multiple lytic lesions. In recent years, the name has shortened to myeloma, but Wolf says that it is time to change it back, because it signifies that there are different types of myeloma. Patients with standard-risk multiple myeloma usually have a very good prognosis, with some living for 20 years with their cancer. Conversely, there is a high-risk pattern that affects about 20% to 25% of patients who rarely live past 2 years, says Wolf.
These high-risk patients can be identified by fluorescence in situ hybridization (FISH) or by doing gene expression profiling. Wolf says that identifying this population is important because it can guide treatment decision. There are early data suggesting that maintenance therapy after an autologous stem cell transplant can make a difference in these patients. Additionally, using multiple agents may be more effective than using 1, and potentially change their risk from high to standard, Wolf explains.