Abstract
Over the past decade, 2 strategies have advanced the treatment of patients with multiple myeloma and its precursor diseases. First, the definition has changed to include patients without end organ damage, who previously would not have been treated. Second, there is widespread enthusiasm for treating high-risk, smoldering multiple myeloma. In this commentary, we explore the evidence supporting these therapeutic expansions. Although early treatment adds cost and therapeutic burden, it remains unknown whether survival and health-related quality of life are improved by early treatment. Herein, we consider the implications of diagnostic expansion in multiple myeloma.
© 2021 by The American Society of Hematology.
MeSH terms
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Antineoplastic Combined Chemotherapy Protocols / economics
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use
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Asymptomatic Diseases
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Cost of Illness
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Dexamethasone / administration & dosage
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Disease Progression
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Early Detection of Cancer
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Humans
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Immunoglobulin Light Chains / analysis
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Immunologic Factors / therapeutic use
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Lenalidomide / administration & dosage
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Lenalidomide / economics
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Multiple Myeloma / diagnosis*
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Multiple Myeloma / drug therapy
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Multiple Myeloma / economics
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Myeloma Proteins / analysis
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Protease Inhibitors / therapeutic use
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Quality of Life
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Randomized Controlled Trials as Topic
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Risk Assessment
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Smoldering Multiple Myeloma / classification
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Smoldering Multiple Myeloma / diagnosis*
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Smoldering Multiple Myeloma / drug therapy
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Smoldering Multiple Myeloma / economics
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Time-to-Treatment
Substances
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Immunoglobulin Light Chains
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Immunologic Factors
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Myeloma Proteins
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Protease Inhibitors
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Dexamethasone
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Lenalidomide