Multiple myeloma remains a highly treatable but incurable disease. New agents with improved efficacy have increased the response to induction treatment. These agents have been adapted for use in maintenance therapy strategies to improve responses and delay relapse/progression with the ultimate goal of improved overall survival. Recent trials have shown that the immunomodulatory drugs thalidomide and lenalidomide; the proteasome inhibitor bortezomib; and the bisphosphonate zoledronate improve time to progression and overall survival. Introduction of new therapies, alone or in combination with existing agents, may lead to increased improvement and prolongation of disease control after autologous hematopoietic stem cell transplantation for transplant-eligible patients.
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Potjana Jitawatanarat, Arpita Desai, Pradeep Sharda, Hong Liu, Maureen Ross, Francisco J. Hernandez-llizaliturri, Philip L. McCarthy, and George L. Chen
This case report presents a patient with poor-prognosis chronic lymphocytic leukemia (CLL) who was treated with chemotherapy and underwent allogeneic hematopoietic cell transplant (alloHCT) but ultimately progressed. The application of the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for CLL and the impact of alloHCT on secondary therapy for progressive CLL are discussed.