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Multiple Myeloma: Advances in Diagnosis and Treatment
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Multiple Myeloma: Advances in Diagnosis and Treatment

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: 25 July 2025 | Viewed by 3103

Special Issue Editor

Dr. Martina Kleber

E-Mail Website
Guest Editor
1. Department of Internal Medicine, Clinic Hirslanden Zurich, 8032 Zurich, Switzerland
2. Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056 Basel, Switzerland
Interests: multiple myeloma; bood and marrow transplantation; hematology; hematopoietic cell transplantation; Waldenström’s macroglobulinemia; AL amyloidosis; liver cancer; meta-analysis; immunotherapy

Special Issue Information

Dear Colleagues,

Multiple myeloma is characterized as a complex hematological malignancy with abnormal plasma cell proliferation. During the last decade, remarkable advances in the diagnosis and treatment of multiple myeloma have been made. Due to increased understandings of the pathogensis of multiple myeloma, including clonal evolution, its microenviroment, the role of circulating cells and the innovation of diagnostic techniques, significant developments in detecting and monitoring multiple myeloma could be observed in the near future. Though advances in multiple myeloma could be achieved and translated into improved patients outcomes, ongoing research efforts are focusing on the treatment of relapsed/refractory multiple myeloma patients to explore novel therapeutic agents such as chimeric antigen reseptor (CAR), T-cell therapy, or bispecific T-cell engager (BiTE) treatment modalities and their mechanisms of resistance. In parallel, the exploration of non-immune therapy options in replased/refactory multiple myeloma and combination therapies to optimize therapy efficacy and adverse effects will hopefully expand the availability of therapies for multiple myeloma patients. Not only the treatment of refractory/relapsed myeloma, but also the extent to which precursor conditions such as MGUS or smoldering myeloma need to be treated, are topics for further analysis, which could greatly improve the current landscape of plasma cell dyscrasias.

We look forward to receiving your submissions.

Dr. Martina Kleber
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • multiple myeloma
  • early intervention
  • novel therapies
  • treatment approach
  • prognosis
  • bispecific antibodies
  • CAR T-cells

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Published Papers (2 papers)

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25 pages, 1118 KiB  
Review
Current Treatment Strategies for Multiple Myeloma at First Relapse
by Evangelos Mavrothalassitis, Konstantinos Triantafyllakis, Panagiotis Malandrakis, Maria Gavriatopoulou, Martina Kleber and Ioannis Ntanasis-Stathopoulos
J. Clin. Med. 2025, 14(5), 1655; https://doi.org/10.3390/jcm14051655 - 28 Feb 2025
Viewed by 2274
Abstract
Multiple myeloma (MM), the second most common hematologic cancer, remains an incurable malignancy, characterized by an initial response to therapy followed by successive relapses. The upfront treatment typically involves induction therapy, autologous stem cell transplantation for eligible patients, and long-term maintenance therapy. It [...] Read more.
Multiple myeloma (MM), the second most common hematologic cancer, remains an incurable malignancy, characterized by an initial response to therapy followed by successive relapses. The upfront treatment typically involves induction therapy, autologous stem cell transplantation for eligible patients, and long-term maintenance therapy. It is important to note that the anticipated duration of myeloma response diminishes with each subsequent relapse. Therefore, the first relapse represents a critical juncture in treatment, where refractoriness to key drug classes emerges as a significant challenge. Addressing the optimal management in this setting requires careful consideration of disease biology, prior therapies, and patient-specific factors to optimize outcomes. Cilta-cel, a chimeric antigen receptor T-cell construct, has emerged as the most promising therapeutic option at first relapse, resulting in long-term remissions with a significant treatment-free interval. However, availability and accessibility are not universal and treatment logistics are complex. Triplet regimens based on carfilzomib, pomalidomide or selinexor, remain the cornerstone of treatment at first relapse, whereas the optimal combination is based on refractoriness to prior drugs, especially anti-CD38 monoclonal antibodies and lenalidomide, and patient comorbidities. With the rapidly expanding therapeutic landscape, clinicians face increasing complexity in selecting the most appropriate regimens for individual patients. This review aims to guide clinicians through these evolving options by consolidating evidence-based strategies and highlighting emerging therapies, ensuring a personalized approach to managing first-relapse MM. Full article
(This article belongs to the Special Issue Multiple Myeloma: Advances in Diagnosis and Treatment)
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12 pages, 204 KiB  
Case Report
Multiorgan Failure Resembling Grade 5 (Fatal) Cytokine Release Syndrome in Patient with Multiple Myeloma Following Carfilzomib Infusion: A Case Report
by Strahinja Gligorevic, Nebojsa Brezic, Joshua Jagodzinski, Andjela Radulovic, Aleksandar Peranovic and Igor Dumic
J. Clin. Med. 2025, 14(13), 4723; https://doi.org/10.3390/jcm14134723 - 3 Jul 2025
Viewed by 210
Abstract
Background: Cytokine release syndrome (CRS) is a life-threatening systemic inflammatory condition marked by excessive cytokine production, leading to multi-organ dysfunction. It is commonly associated with T-cell-engaging therapies such as chimeric antigen receptor (CAR) T cells, T-cell receptor bispecific molecules, and monoclonal antibodies. Carfilzomib, [...] Read more.
Background: Cytokine release syndrome (CRS) is a life-threatening systemic inflammatory condition marked by excessive cytokine production, leading to multi-organ dysfunction. It is commonly associated with T-cell-engaging therapies such as chimeric antigen receptor (CAR) T cells, T-cell receptor bispecific molecules, and monoclonal antibodies. Carfilzomib, a proteasome inhibitor, is known to cause a range of adverse effects, primarily hematologic and cardiovascular. However, multiorgan failure grade 5 (fatal), resembling CRS has not been previously reported in association with Carfilzomib. Case Report: A 74-year-old male with relapsed multiple myeloma developed grade 5 multiorgan failure 60 min after the third dose of Carfilzomib, resulting in death within 24 h of symptom onset. The patient tolerated the first doses of Carfilzomib well with only fever and headache developing post infusion. Before the second dose, the patient developed worsening pancytopenia, prompting the discontinuation of Lenalidomide. After the second Carfilzomib infusion, he experienced fever and transient encephalopathy, which resolved with acetaminophen, corticosteroids, and supportive care. However, following the third dose, he rapidly deteriorated—developing fever, tachycardia, hypotension, hypoxia, and encephalopathy. Despite aggressive management with intravenous fluids, broad-spectrum antibiotics, corticosteroids, and tocilizumab, the patient progressed to refractory shock and multi-organ failure, culminating in death within 24 h. A comprehensive infectious workup was negative, ruling out sepsis and suggesting possible Carfilzomib-induced CRS. Conclusion: Grade 5 multiorgan failure with signs and symptoms similar with CRS following Carfilzomib administration is a rare but potentially fatal adverse drug reaction. Further research is needed to better define the risk factors and optimal management strategies for Carfilzomib-induced multiorgan failure and possible CRS. Full article
(This article belongs to the Special Issue Multiple Myeloma: Advances in Diagnosis and Treatment)
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