Preface

Chapter 8 **Allogeneic Hematopoetic Cell Transplantation in**

Pervin Topcuoglu, Sinem Civriz Bozdag and Taner Demirer

Je-Jung Lee, Youn-Kyung Lee, Hyun Ju Lee, Sung-Hoon Jung and

Mariam Boota, Joshua Bornhorst, Zeba Singh and Saad Z. Usmani

Maja Hinge, Thomas Lund, Jean-Marie Delaisse and Torben Plesner

Chapter 9 **Cellular Immunotherapy Using Dendritic Cells in Multiple Myeloma: New Concept to Enhance Efficacy 179**

Chapter 10 **Novel Prognostic Modalities in Multiple Myeloma 199**

Emine Ozyuvaci, Onat Akyol and Tolga Sitilci

Chapter 14 **Quality of Life Issues of Patients with Multiple Myeloma 275**

Chapter 15 **Multiple Myeloma in Horses, Dogs and Cats: A Comparative**

**Review Focused on Clinical Signs and Pathogenesis 289** A. Muñoz, C. Riber, K. Satué, P. Trigo, M. Gómez-Díez and F.M.

**Multiple Myeloma 165**

**VI** Contents

Thanh-Nhan Nguyen-Pham

Chapter 11 **Bone Disease in Multiple Myeloma 217**

Artur Jurczyszyn

Castejón

Chapter 13 **Pain and Multiple Myeloma 259**

Klára Gadó and Gyula Domján

Chapter 12 **Rare Manifestations of Multiple Myeloma 241**

Multiple myeloma is the second most common haematological malignancy. This book does not provide a comprehensive overview of the disease but offers a collection of chapters with in-depth information on distinct hot topics in the diagnostic, research and therapeutic fields. On the biological side, the authors show plasticity of myeloma cells and describe the innova‐ tive models to assess multiple myeloma biology. On the clinical side, the authors analyse current therapeutic development. Pharmacotherapy of multiple myeloma is an example of the fast introduction of scientific discoveries into clinics. The dynamics of testing new drugs for multiple myeloma treatment in clinical trials is breathtaking. Scientific discoveries have uncovered complicated pathogenesis of multiple myeloma; complicated reactions to treat‐ ment lead to creation of super cocktails. This strategy is most beneficial for the patient, but it is not yet personalized medicine. The curability of multiple myeloma is a question that is being discussed by the entire professional myeloma world. Regardless of your position in this debate, some professionals are missing the vital point in this debate - the incredible im‐ provement in treatment options. Consequently, improvement of prognosis is a fact which is most important from a patient's perspective.

This book will be of interest to medical professionals specializing in hematooncology, re‐ searchers, as well as many others.

> **Prof. Roman Hajek** Department of Pathological Physiology, Faculty of Medicine, Masaryk University, Czech Republic

**Chapter 1**

**Strategies for the Treatment of Multiple Myeloma**

Multiple myeloma (MM) is a hematooncological disease, and in recent years, overall survival of patients has been significantly increased. Improvement of treatment results is connected not only to the introduction of autologous transplantation of hematopoietic cells into the treatment strategy for younger patients in the 90s but also to the introduction of new beneficial drugs into clinics; in the first decade of this century, bortezomib, thalidomide and lenalidomide were introduced in [1]. These new drugs have repeatedly proven their high treatment efficacy in clinics in all age groups of patients, in primotherapy as well as refractory disease. There are also newer drugs currently under investigation, such as new proteasome inhibitors (carfilzo‐ mib, MLN9708 and other peroral proteasome inhibitors) and other immunomodulatory drugs (pomalidomide) with the aim to improve or maintain treatment effects and decrease unfav‐ orable effects in [2]. Using drugs from both these groups together with glucocorticoids and alkylating cytostatics had a major impact on prolonging survival of our patients as previously published. On the other hand, it is clear that use of only one of the new efficient drugs in combination with glucocorticoids and alkylating cytostatics does not lead to a cure in [3-7]. Optimization of dosage in combination with other drugs and the length of treatment have been clarified for thalidomide and bortezomib. Current dosage levels are different from recorded dosages in registration studies which in certain cases led to common or higher level of side effects than is acceptable; these side effects are reduced after optimization. Side effects, especially the long-term ones, may fundamentally influence the quality of life of patients after successful treatment. Nowadays, optimization of thalidomide and bortezomib treatments is almost completed and lenalidomide optimization is currently being processed in [5]. It is logical to think that optimization of efficient drugs is a never ending process that waits for each new efficient drug, for example carfilzomib and pomalidomide in the near future. A

> © 2013 Hajek; licensee InTech. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

© 2013 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution,

distribution, and reproduction in any medium, provided the original work is properly cited.

and reproduction in any medium, provided the original work is properly cited.

**in 2013: Moving Toward the Cure**

Additional information is available at the end of the chapter

Roman Hajek

**1. Introduction**

http://dx.doi.org/10.5772/55366
