The Whirlwind of ASH Slows
The whirlwind of #ASH24 has slowed down and now it is time to digest all the info we have seen presented. Every year, I find it very important to review IMF Chairperson of the Board Dr. S. Vincent Rajkumar’s updated myeloma treatment algorithms based on the data presented at ASH. It is exciting to see new research implemented into his guidelines yearly. Dr. Rajkumar is careful to say that these are general principles and that treatments evolve and individualized treatment is a priority. He also says that, in general, a clinical trial is preferable if one is possible and available. With a trial, so that more can be learned. So much work in myeloma research across the globe goes into what is presented here at ASH—I”m so grateful to all.
I wanted to start this blog by including a photo of the IMF’s newly formed Scientific Advisory Board (SAB). (It is this blog’s main photo.) I am so proud and excited for their input into research in the future. So much #myeloma greatness in this photograph and more importantly, kindness, integrity, and passion to better the lives of myeloma patients everywhere. Thank you, SAB!
Dr. Rajkumar’s annually updated myeloma treatment algorithms:
Newly diagnosed, transplant ineligible. Quadruplet induction unless frail. Maintenance varies by risk stratification
Newly diagnosed, transplant eligible. Quadruplet induction.
First relapse. Dr. Rajkumar doesn’t recommend CAR-T in first relapse, even though it’s approved, except in very selected patients (eg., high risk progressing early while on quad therapy)
Second or later relapse.
True Penta-refractory myeloma (refractory to a proteasome inhibitor, or PI; an immunomodulatory drug, or IMID; a CD38, alkylator; and BCMA-targeted approach):
