Management of multiple myeloma: the changing landscape.

Many changes have been incorporated into the approach to multiple myeloma over the last few years, due to improvements in our understanding of the disease biology. New diagnostic and prognostic criteria from the International Myeloma Working Group have clarified the initial clinical approach to this disease. The prognostic impact of chromosomal abnormalities is now recognized, and the detection of specific abnormal cytogenetics is beginning to influence therapeutic decisions. The introduction of the novel agents thalidomide, bortezomib and lenalidomide has expanded treatment options at different points in the disease course; these agents are being evaluated in conjunction with conventional chemotherapy and stem cell transplantation. This report highlights some of the key recent findings in multiple myeloma, and describes areas for future research.