Cancer: Principles and Practice of Oncology. They include: Your doctor may also prescribe these. This can mean targeting the blood vessels that feed tumors or attacking specific genetic and proteins of cancer. The risk of blood clots is not as high as that seen with thalidomide, but it is still increased. Don't be afraid to talk to your doctor or nurse if you don't understand how to take your medicine. Common side effects of these drugs include. Bildergalerie: Achtung, Autofahrer: Diese Medikamente sind tabu! Multiple Myeloma (MM) is a deadly blood cancer that often infiltrates the bone marrow causing anemia, kidney failure, immune problems, and bone fractures. It may be especially helpful in treating myeloma patients with kidney problems. They are given carefully to avoid or reduce the side effects of chemotherapy. In diesem Fall kommen bei der Behandlung in der Regel Medikamente zum Einsatz. Entartete Plasmazellen hingegen produzieren veränderte, meist funktionslose Antikörper (Paraproteine). Any tooth or gum infections should be treated right away. Carfilzomib (Kyprolis) is a newer proteasome inhibitor that can be used to treat multiple myeloma in patients who have already been treated with other drugs that didn't work. Mediziner bezeichnen diese Antikörper und Antikörperfragmente auch als Paraproteine. Demzufolge ist die Erkrankung therapiepflichtig, wenn der Anteil der Plasmazellen im Knochenmark mindestens zehn Prozent beträgt und mindestens einer der folgenden Punkte erfüllt ist: Neben den SLiM-CRAB-Kriterien sprechen in einigen Fällen auch andere Gründe für eine Therapie, wie zum Beispiel: Außerdem berücksichtigt der Arzt, wie hoch das Risiko ist, dass sich die Symptome und Organfunktionen ohne Behandlung verschlechtern. Sobald es aber Anzeichen dafür gibt, dass der Knochenmarkkrebs bereits den Körper schädigt, ist eine Therapie unverzichtbar - auch wenn sich der Patient möglicherweise gesund fühlt. Either form of this drug can cause a reaction in some people while it is being given or within several hours afterward, which can sometimes be severe. American Society of Clinical Oncology: “Multiple Myeloma: Types of Treatment.”, Mayo Clinic Proceedings: “Multiple Myeloma: Diagnosis and Treatment.”, Blood Cancer Journal: “Multiple myeloma current treatment algorithms.”, Journal of Oncology Navigation & Survivorship: “Triplet Therapy: A New Standard for Multiple Myeloma.”, National Comprehensive Cancer Network: “NCCN Guidelines for Patients: Multiple Myeloma, 2022.”, Multiple Myeloma Research Foundation: “Personalized treatment plans,” “Drug therapies for multiple myeloma,” “Proteasome inhibitors.”, American Cancer Society: “Drug Therapy for Multiple Myeloma.”, The Lancet: “Bortezomib with lenalidomide and dexamethasone versus lenalidomide and dexamethasone alone in patients with newly diagnosed myeloma without intent for immediate autologous stem-cell transplant (SWOG S0777): a randomised, open-label, phase 3 trial.”. Get information on patient appointments, insurance and billing, and directions to and around MD Anderson. If you have multiple myeloma, remember that you often have a lot of choices in how to treat it. Welche Krankheit verursacht meine Beschwerden? Sometimes, pain medicines such as NSAIDs or narcotics will be given along with bisphosphonates to help control or lessen the pain. Sometimes you'll get them along with your chemotherapy so you have less nausea and vomiting during treatment. You get them either as a shot through your skin, an IV into your vein, or a pill. MD Anderson offers the most up-to-date and advanced chemotherapy options. Außerdem wirkt diese kombinierte Behandlung nicht bei allen Betroffenen, sodass es zu Rückfällen kommt. Combination Therapy With Histone Deacetylase Inhibitors (HDACi) for the Treatment of Cancer: Achieving the Full Therapeutic Potential of HDACi. Es ist jedoch dank verbesserter Behandlungsoptionen mittlerweile möglich, lange krankheitsfreie Phasen zu erreichen. . These tests may not be performed in all cases. 1,2,3 Who is eligible for an autologous stem cell transplant? Erhalten Sie die neuesten Nachrichten und wertvolleTipps rund um Ihre Gesundheit. Instead, call your doctor's office and talk about your options. Für symptomatische Myelompatient*innen stehen eine Vielzahl von Therapieoptionen zur Verfügung. Sie und alle ihre Nachkommen produzieren große Mengen eines einzigen monoklonalen Antikörpers. Learn about our graduate medical education residency and fellowship opportunities. Chemotherapy. Side effects may include nausea, diarrhea, hair loss, mouth sores and fatigue. Dr. med. Are not active or need help with personal care, Have certain health problems, including kidney or. They’re also at risk for bleeding due to lack of platelets. Antikörper eines einzigen Typs bezeichnen Mediziner auch als monoklonale Antikörper. Laboratory analysis of your blood may reveal the M proteins produced by myeloma cells. These medications help your immune system fight cancer cells in your blood. Sie finden sich z.B. 2017; 111:87-93. They appear to affect tumor cells more than normal cells, but they are not without side effects. Neue therapeutische Möglichkeiten haben zu Zulassungen von weiteren Medikamenten geführt - neuen Proteasominhibitoren, immunmodulatorischen Substanzen und monoklonalen Antikörpern. They do this by interacting with proteins in chromosomes called histones. Bone problems. Examples are: Monoclonal antibodies. Die entarteten Antikörper sind im Blut anhand eines erhöhten Gesamteiweiß-Spiegels nachweisbar. This drug is used mainly in patients who have already had other treatments for their myeloma. Zum anderen setzen die Antikörper im Inneren der Tumorzelle eine Reaktionskette in Gang, die die Zelle letztlich abtötet. Medikamentöse Therapie. They allow protein to build up inside cancer cells until it kills them. Be sure to contact your health care team right away if you have any symptoms that might be from CRS. Multiple myeloma. Das Multiple Myelom (MM) ist charakterisiert durch eine monoklonale Plasmazellvermehrung im Knochenmark mit vermehrter Produktion . The drugs used most often for treating bone problems in people with myeloma are the bisphosphonates pamidronate (Aredia) and zoledronic acid (Zometa) and the drug denosumab (Xgeva, Prolia). Heute überleben Betroffene im Schnitt für etwa fünf bis zehn Jahre nach der Diagnose. © 2023 The University of Texas MD Anderson Nicht jeder Patient mit einem Multiplen Myelom muss aber sofort behandelt werden. Auch die Bildung von Blutplättchen (Thrombozyten) ist beim Multiplen Myelom beeinträchtigt. Common side effects include low platelet counts, low white blood cell counts, diarrhea, nausea, vomiting, not feeling hungry, weight loss, low blood sodium levels, and infections like bronchitis or pneumonia. Erste Hinweise auf die Erkrankung liefern dem Arzt bereits die typischen Symptome wie Knochenschmerzen, eine höhere Infektanfälligkeit, schäumender Urin oder Gewichtsverlust. Ein Blutbild hilft zudem, veränderte Nierenwerte festzustellen, wenn Bence-Jones-Proteine das Nierengewebe schädigen und die Nierenfunktion dadurch nachlässt. Deshalb ist im Anschluss eine sogenannte autologe Stammzelltransplantation erforderlich: Dabei erhält der Betroffene körpereigene Stammzellen, die vor der Chemotherapie aus seinem Blut gewonnen wurden. The side effects that you might have from multiple myeloma treatment include: Talk to your doctor about how your treatment makes you feel. It’s given as an injection into a vein (IV), often in a 4-week cycle. What is an autologous stem cell transplant? Welches Stadium bei einem Betroffenen vorliegt, richtet sich nach der Höhe bestimmter Blutwerte und danach, ob eine Hochrisikomutation vorhanden ist. The powerful treatment kills not only cancer cells, but also healthy, blood-forming stem cells. In einigen Fällen sind es auch nur Bruchstücke dieses Antikörpers, die sogenannten Kappa- und Lambda-Leichtketten. Leukemia patients usually receive an allogeneic stem cell transplant. Corticosteroids are also used to help decrease the nausea and vomiting that chemo might cause. Individuell lässt sich die Lebenserwartung beim Multiplen Myelom oder Plasmozytom nicht genau prognostizieren. 1,2 Previous studies have shown that performance status . Some activate certain immune cells, while others prevent cancer cells from putting out growth cells. Dabei entnimmt er unter örtlicher Betäubung mit einer Nadel Knochenmark aus einem geeigneten Knochen, in der Regel dem Beckenkamm. You’ll keep taking it until it stops working. Most autologous transplant patients see a steady return to normal blood counts within two to four weeks. This drug can also lower blood cell counts: This drug might also increase your risk of developing a second cancer. The treatment plan that you and your doctor choose will depend on: There are several types of drugs that are effective in treating multiple myeloma. (Dental fillings, root canal procedures, and tooth crowns do not seem to lead to ONJ.) It works well in treating multiple myeloma. What are the steps in an autologous stem cell transplant? Rajkumar SV, Dispenzieri A. Coronavirus oder Grippe? Beim Multiplen Myelom kommt es in einer der vielen Plasmazellen zu Veränderungen im Erbgut (Mutation). The way immunomodulating agents affect the immune system isn’t entirely clear. Wir bieten Ihnen unabhängige und umfassende Informationen rund um die Themen Gesundheit und Krankheit. For example: The choice and dose of drug therapy depend on many factors, including the stage of the cancer, the age and kidney function of the patient as well as how frail the patient may be. Your medications will work better against your cancer if you take them as prescribed. You might get: Proteasome inhibitors. It uses your own immune cells to fight off cancer cells. See if you're eligible for a clinical trial. They include: These drugs block a protein called XPO1.  Myeloma cells are then unable to transport proteins properly and the cancer cells die: This treatment is not approved for multiple myeloma yet, but it is being tested to see how safe it is and how well it works. Einige Menschen versterben bereits nach wenigen Monaten, andere leben länger als zehn Jahre. Common side effects of this drug include nausea and vomiting, tiredness, diarrhea, constipation, fever, decreased appetite, and lowered blood counts. Others, particularly those with multiple myeloma, may receive a planned second transplant several months after the first one. Bei allen Angaben zur Lebenserwartung handelt es sich um Durchschnittswerte. Teclistamab can be used to treat multiple myeloma that no longer responds to at least 4 other myeloma drugs, including proteasome inhibitors, immunomodulatory drugs, and a monoclonal antibody to CD38. Learn about clinical trials at MD Anderson and search our database for open studies. Ein Multiples Myelom bezeichnet eine Krankheitsform, bei der die wuchernden, bösartigen Plasmazellen diffus im Knochenmark oder im Weichteilgewebe verteilt sind. This can lead to an open sore that doesn’t heal. Philadelphia, PA: Lippincott Williams & Wilkins; 2015. National Cancer Institute: “CAR T Cells: Engineering Patients' Immune Cells to Treat Their Cancers.”, Multiple Myeloma Research Foundation: “Radiation Therapy for Multiple Myeloma,” “Standard Treatments,” “Symptoms, Side effects and Complications.”, American Cancer Society: “Drug Therapy for Multiple Myeloma,” “Supportive Treatments for Patients With Multiple Myeloma.”, The Lancet Oncology: “Denosumab versus zoledronic acid in bone disease treatment of newly diagnosed multiple myeloma: an international, double-blind, double-dummy, randomised, controlled, phase 3 study.”, NYU Langone Health / Pearlmutter Cancer Center: “Watchful Waiting for Multiple Myeloma.”. Your doctor will do blood and bone marrow tests to see how the treatment is working. Das multiple Myelom ist ein vom Knochenmark ausgehender, relativ seltener Tumor. Bei Gesunden liegt der Anteil von Plasmazellen in der Regel bei maximal fünf Prozent. One type of transplant, called an allogeneic transplant, uses stem cells from a donor. Physician Relations Continuing Education Program, Specialized Programs of Research Excellence (SPORE) Grants, Prevention & Personalized Risk Assessment, MD Anderson UTHealth Houston Graduate School, Comparative Effectiveness Training (CERTaIN), Cancer Survivorship Professional Education, Post Graduate Fellowship in Oncology Nursing, Argyros Postdoctoral Research Fellowship in Oncology Nursing, Professional Student Nurse Extern Programs, Autologous stem cell transplants: What to expect, Request an appointment at MD Anderson online, CT or CAT (computed axial tomography) scans, Monoclonal antibodies, including Darzalex (daratumumab) and Empliciti (elotuzumab), Chimeric antigen receptor (CAR) T cells, which are genetically modified T cells that fight the myeloma directly, Bispecific t cell engagers, which help activate and get your own immune cells next to myeloma cells in your body to kill them, red blood cells to carry oxygen throughout the body. Bei Betroffenen unter 75 Jahren handelt es sich bei der hochdosierten Chemotherapie mit Stammzelltransplantation um das aktuelle Standardverfahren. Im Stadium 2 beträgt sie 62 Prozent, im Stadium 3 noch 40 Prozent. In the standard treatment, your doctor collects some of your own stem cells from your blood and gives them back to you. All rights reserved. Isatuximab (Sarclisa) is another monoclonal antibody that attaches to the CD38 protein on myeloma cells. Allerdings tritt die Erkrankung in seltenen Fällen gehäuft innerhalb einer Familie auf. They can also help reduce pain in the weakened bone(s). Konsultationsfassung 2021, unter: www.leitlinienprogramm-onkologie.de (Abrufdatum: 17.11.2021), Pschyrembel Online: Proteasom-Hemmer, unter: www.pschyrembel.de (Abrufdatum: 17.11.2021), Suraweera A. et al. Es gibt jedoch bestimmte Risikofaktoren, die im Verdacht stehen, ein Multiples Myelom zu begünstigen. © {currentyear} American Cancer Society, Inc. All rights reserved. Multiple myeloma is a type of cancer that occurs when an atypical plasma cell develops in the bone marrow and reproduces quickly. In patients with multiple myeloma (MM), CAR T-cell therapy has been investigated in clinical trials. Most patients need only a single autologous transplant. Nat Rev Clin Oncol. Behandlung des Multiplen Myeloms im CIO Nähere Informationen zur Behandlung des Multiplen Myeloms im CIO (inkl. Definition Das Multiple Myelom, kurz MM, ist eine maligne Erkrankung, die zu den B-Zell-Lymphomen gerechnet wird. A typical radiation treatment plan for a patient with multiple myeloma includes five sessions a week for approximately two weeks. They may also test your cancer cells, looking for parts that can be attacked by particular drugs. Palumbo A, Anderson K. Multiple myeloma. The main types of drugs used in triplet therapy are: Corticosteroids. Symptoms can include coughing, wheezing, trouble breathing, tightness in the throat, a runny or stuffy nose, feeling dizzy or lightheaded, headache, rash, and nausea.
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