Dr. Costello on Considerations for Induction Therapy Selection in Multiple Myeloma

Caitlin Costello, MD, hematologist/medical oncologist, assistant professor of medicine, University of California, San Diego ​Health, discusses considerations for induction therapy selection in multiple myeloma.

Patient and disease characteristics should inform first-line induction therapy selection, says Costello. Additionally, transplant eligibility status should be determined at presentation, regardless of the long-term treatment plan, Costello explains.

Transplant status may be difficult to determine because some patients present with uncontrolled disease and poor performance status, Costello says. In those cases, induction therapy may control the patient’s disease and allow them to undergo transplant.

Upon disease progression, subsequent lines of therapy can be informed by evaluating the type of relapse the patient is having, while also factoring in patient and disease characteristics, Costello says. Patients may have aggressive relapses and develop plasmacytomas and anemia. Conversely, they may have biochemical progression, which is characterized by slowly increasing paraprotein, concludes Costello.