Advances in the treatment and management of Filipino patients with multiple myeloma: From deadly to chronic disease with possibility of remission

ABSTRACT

BACKGROUND@#Multiple myeloma is a malignant proliferation of plasma cells that accumulate in the bone marrow and results in several organ dysfunctions that are debilitating and fatal. For the past 20 years, advances in the understanding of genetic abnormalities, interactions in the bone marrow microenvironment, developments in the diagnosis and staging in myeloma and introduction and incorporation of novel agents early in the disease course have been pivotal in the clinical treatment and management of patients with multiple myeloma. However, the burden associated with the disease, including treatment costs, is significant for Filipino patients as it is still incurable. In the Philippines, the introduction of bortezomib in the market in the last decade have brought hope to many patients by expanding the availability of treatment options, improving quality of life and extending survival. @*METHODS@#This paper documents the proceedings of a forum on multiple myeloma conducted last March 2018 at Makati City. The purpose of the forum was to discuss the major clinical presentations of the disease as well as treatment and management of selected patients. Speakers were hematology and medical oncology experts in the Philippines.@*RESULTS@#Five cases of multiple myeloma with different clinical presentations and management were discussed (1) renal insufficiency, (2) easy fatigability, (3) bone pain, (4) autologous stem cell/bone marrow transplantation and (5) coagulopathy. Short videos of selected patients (or their family members) after each presentation was showed, describing their treatment journey with myeloma. Other patients with multiple myeloma who were treated with bortezomib were present in the forum and briefly shared their experiences.@*CONCLUSION@#As multiple myeloma is a highly heterogeneous molecular disease, approaches and provision of care will need to be individualized for each patient. Because of its impressive performance, bortezomib is likely to continue being an important part of the clinical treatment and management of Filipino patients with myeloma.