In the last decades big changes were achieved in a field of multiple myeloma treatment. Cardinal change came with introduction of so-called novel agents - bortezomib, thalidomide and lenalidomide. Their benefit for effectivity of treatment and improvement of prognosis in patients with multiple myeloma was proven by many large clinical trials. To achieve best treatment outcome, the choice of frontline therapy is probably crucial, with aim to achieve best possible treatment response. The best choice in Czech health care system is bortezomib-based induction followed by an autologous stem-cell transplant as a consolidation. For old patients, unable to undergo autolgous stem-cell transplant, situation is similar - best results are achieved by bortezomib-based induction. Both groups of patients shloud profit from lenalidomide maintenance, which is not covered by Czech health system. In a next few years, extension of treatment possibilities is expected with next generation of novel agents, which are now available only for clinical trials or in a relapsed disease.
Key words: bortezomib - frontline therapy - lenalidomide - multiple myeloma - multiple myeloma treatment - thalidomide.