Dr. Galligan the Utility of Up-front High-Intensity Therapy in Multiple Myeloma

Derek C. Galligan, MD, medical oncologist, Center for Health & Healing Building, Oregon Health & Science University, discusses the utility of up-front high-intensity therapy for patients with multiple myeloma.

In general, patients with newly diagnosed multiple myeloma have low symptom burden and can wait a short period of time before initiating therapy, Galligan says.

However, some patients with myeloma present with renal failure, hyperviscosity syndrome, or extensive bone disease, says Galligan. In these cases, patients require immediate inpatient treatment.

One high-intensity option is modified hyper-CVAD [cyclophosphamide, vincristine, doxorubicin, and dexamethasone] with or without proteasome inhibitors, says Galligan. Modified hyper-CVAD plus best supportive care has been shown to help control disease and reverse organ damage.

Moreover, some patients can come off dialysis with the regimen, concludes Galligan.