{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T17:59:26Z","timestamp":1792605566932,"version":"4.5.0"},"reference-count":101,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2020,11,24]],"date-time":"2020-11-24T00:00:00Z","timestamp":1606176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Myeloma therapeutic strategies have been adapted to patients\u2019 age and comorbidities for a long time. However, although cytogenetics and clinical presentations (plasmablastic cytology; extramedullary disease) are major prognostic factors, until recently, all patients received the same treatment whatever their initial risk. No strong evidence allows us to use a personalized treatment according to one cytogenetic abnormality in newly diagnosed myeloma. Retrospective studies showed a benefit of a double autologous transplant in high-risk cytogenetics according to the International Myeloma Working Group definition (t(4;14), t(14;16) or del(17p)). Moreover, this definition has to be updated since other independent abnormalities, namely gain 1q, del(1p32), and trisomies 5 or 21, as well as TP53 mutations, are also prognostic. Another very strong predictive tool is the response to treatment assessed by the evaluation of minimal residual disease (MRD). We are convinced that the time has come to use it to adapt the strategy to a dynamic risk. Many trials are ongoing to answer many questions: when and how should we adapt the therapy, its intensity and duration. Nevertheless, we also have to take into account the clinical outcome for one patient, especially adverse events affecting his or her quality of life and his or her preferences for continuous\/fixed duration treatment.<\/jats:p>","DOI":"10.3390\/cancers12123497","type":"journal-article","created":{"date-parts":[[2020,11,24]],"date-time":"2020-11-24T09:06:28Z","timestamp":1606208788000},"page":"3497","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Risk and Response-Adapted Treatment in Multiple Myeloma"],"prefix":"10.3390","volume":"12","author":[{"given":"Titouan","family":"Cazaubiel","sequence":"first","affiliation":[{"name":"Hematology Department, University Hospital, 33600 Bordeaux, France"},{"name":"Centre de Recherche en Canc\u00e9rologie de Toulouse, Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale U1037, 31059 Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Mulas","sequence":"additional","affiliation":[{"name":"Hematology Unit, Businco Hospital, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lydia","family":"Montes","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital, 80054 Amiens, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5526-4279","authenticated-orcid":false,"given":"Ana\u00efs","family":"Schavgoulidze","sequence":"additional","affiliation":[{"name":"Centre de Recherche en Canc\u00e9rologie de Toulouse, Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale U1037, 31059 Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herv\u00e9","family":"Avet-Loiseau","sequence":"additional","affiliation":[{"name":"Centre de Recherche en Canc\u00e9rologie de Toulouse, Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale U1037, 31059 Toulouse, France"},{"name":"Unit for Genomics in Myeloma, Institut Universitaire du Cancer de Toulouse-Oncopole, University Hospital, 31059 Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Corre","sequence":"additional","affiliation":[{"name":"Centre de Recherche en Canc\u00e9rologie de Toulouse, Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale U1037, 31059 Toulouse, France"},{"name":"Unit for Genomics in Myeloma, Institut Universitaire du Cancer de Toulouse-Oncopole, University Hospital, 31059 Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0131-8689","authenticated-orcid":false,"given":"Aurore","family":"Perrot","sequence":"additional","affiliation":[{"name":"Centre de Recherche en Canc\u00e9rologie de Toulouse, Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale U1037, 31059 Toulouse, France"},{"name":"Hematology Department, Institut Universitaire du Cancer de Toulouse-Oncopole, University Hospital, 31059 Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,11,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"4519","DOI":"10.1182\/blood-2011-06-358812","article-title":"Personalized therapy in multiple myeloma according to patient age and vulnerability: A report of the European Myeloma Network (EMN)","volume":"118","author":"Palumbo","year":"2011","journal-title":"Blood"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"M146","DOI":"10.1093\/gerona\/56.3.M146","article-title":"Frailty in Older AdultsEvidence for a Phenotype","volume":"56","author":"Fried","year":"2001","journal-title":"J. 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