{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T08:43:17Z","timestamp":1790239397920,"version":"4.1.0"},"reference-count":40,"publisher":"American Society of Hematology","issue":"1","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2013,12,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Multiple myeloma (MM) is the second most frequent hematological disease. Two-thirds of newly diagnosed MM patients are more than 65 years of age. Elsewhere in this issue, McCarthy et al discuss the treatment of transplantation candidates; this chapter focuses on the data available concerning therapy for non-transplantation-eligible MM patients. Treatment goals for these non-transplantation-eligible patients should be to prolong survival by achieving the best possible response while ensuring quality of life. Until recently, treatment options were limited to alkylators, but new up-front treatment combinations based on novel agents (proteasome inhibitors and immunomodulatory drugs) plus alkylating agents have significantly improved outcomes. Other nonalkylator induction regimens are also available and provide a novel backbone that may be combined with novel second- and third-generation drugs. Phase 3 data indicate that maintenance therapy or prolonged treatment in elderly patients also improves the quality and duration of clinical responses, extending time to progression and progression-free survival; however, the optimal scheme, appropriate doses, and duration of long-term therapy have not yet been fully determined. The potential for novel treatment regimens to improve the adverse prognosis associated with high-risk cytogenetic profiles also requires further research. In summary, although we have probably doubled the survival of elderly patients, this group requires close monitoring and individualized, dose-modified regimens to improve tolerability and treatment efficacy while maintaining their quality of life.<\/jats:p>","DOI":"10.1182\/asheducation-2013.1.488","type":"journal-article","created":{"date-parts":[[2013,12,6]],"date-time":"2013-12-06T15:51:13Z","timestamp":1386345073000},"page":"488-495","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":37,"title":["How should we treat newly diagnosed multiple myeloma patients?"],"prefix":"10.1182","volume":"2013","author":[{"given":"Mar\u00eda-Victoria","family":"Mateos","sequence":"first","affiliation":[{"name":"Hospital Universitario de Salamanca and"},{"name":"Instituto de Investigaci\u00f3n Biom\u00e9dica de Salamanca, Instituto de Biolog\u00eda Molecular y Celular del C\u00e1ncer (Universidad de Salamanca-Consejo Superior de Investigaciones Cient\u00edficas), Salamanca, Spain; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas F.","family":"San Miguel","sequence":"additional","affiliation":[{"name":"Clinica Universidad de Navarra, Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"234","reference":[{"issue":"5","key":"2019111703384940700_B1","doi-asserted-by":"crossref","first-page":"2516","DOI":"10.1182\/blood-2007-10-116129","article-title":"Improved survival in multiple myeloma and the impact of novel therapies","volume":"111","author":"Kumar","year":"2008","journal-title":"Blood"},{"issue":"11","key":"2019111703384940700_B2","doi-asserted-by":"crossref","first-page":"1600","DOI":"10.1634\/theoncologist.2011-0229","article-title":"Improvement in survival of older adults with multiple myeloma: results of an updated period analysis of SEER data","volume":"16","author":"Pulte","year":"2011","journal-title":"Oncologist"},{"issue":"11","key":"2019111703384940700_B3","doi-asserted-by":"crossref","first-page":"3025","DOI":"10.1182\/blood-2010-09-307645","article-title":"Complete response correlates with long-term progression-free and overall survival in elderly myeloma treated with novel agents: analysis of 1175 patients","volume":"117","author":"Gay","year":"2011","journal-title":"Blood"},{"issue":"12","key":"2019111703384940700_B4","doi-asserted-by":"crossref","first-page":"1627","DOI":"10.1200\/JCO.2010.33.1967","article-title":"Comparison of immunofixation, serum free light chain, and immunophenotyping for response evaluation and prognostication in multiple myeloma","volume":"29","author":"Paiva","year":"2011","journal-title":"J Clin Oncol"},{"issue":"9","key":"2019111703384940700_B5","doi-asserted-by":"crossref","first-page":"1680","DOI":"10.1001\/jama.1969.03160090040009","article-title":"Treatment for multiple myeloma. 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