Multiple Myeloma: Challenges and Opportunities

Multiple myeloma (MM) is a B-cell neoplasm in which malignant plasma cells accumulate in the bone marrow and produce lytic bone lesions and excessive amounts of a monoclonal protein (usually an immunoglobulin of the IgG or IgA type or free light chain). Approximately 14,000 new cases of MM are diagnosed each year in the United States, and the disease accounts for approx 1.9% of all cancer-related deaths (1 ,2 ). Despite significant advances in therapy, the disease remains essentially incurable. The therapy of choice in younger patients is currently high-dose therapy with autologous stem cell transplantation; however, a range of novel therapeutic options have recently become available, creating new opportunities for clinical investigation. The major challenge facing clinicians is to determine which of these new agents or which combination of agents will prove to be the most effective and result in a cure for even a small proportion of patients.