Biology and therapy of multiple myeloma

Douglas E Joshua, Christian Bryant, Caroline Dix, John Gibson and Joy Ho
Med J Aust 2019; 210 (8): . || doi: 10.5694/mja2.50129
Published online: 6 May 2019


  • Genetic sequencing of the myeloma genome has not revealed a specific disease‐determining genetic alteration.
  • Multiple disease subclones exist at diagnosis and vary in clinical importance with time and drug sensitivity.
  • New diagnostic criteria have identified indications for early introduction of therapy.
  • Autologous stem cell transplantation remains an essential component of therapy in young and fit patients.
  • The use of continual suppressive (maintenance) therapy has been established as an important component in therapy.
  • Immune therapies and the harnessing of the innate immune system offer great promise for future treatments.
  • Since 2005, quality of life, supportive therapies, and survival have dramatically improved over a decade of remarkable progress.
  • The common manifestations of multiple myeloma, such as bone pain, fatigue and weight loss, may be non‐specific and are often initially ignored or missed by patients and medical practitioners.
  • Douglas E Joshua
  • Christian Bryant
  • Caroline Dix
  • John Gibson
  • Joy Ho

  • Royal Prince Alfred Hospital, Sydney, NSW

Competing interests:

No relevant disclosures.


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