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Multiple Myeloma: Therapeutic and Management Strategies
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Multiple Myeloma: Therapeutic and Management Strategies

A Special Issue of Journal of Clinical Medicine (ISSN 2077-0383) belonging to the section "Hematology".

Deadline for manuscript submissions: closed (20 June 2026) | Viewed by 3054

Editor

Dr. Terri Parker

E-Mail Website
Guest Editor
Section of Hematology, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06510, USA
Interests: hematology; multiple myeloma; AL amyloidosis; monoclonal gammopathy of undetermined significance (MGUS); plasma cell leukemia

Special Issue Information

Dear Colleagues,

The treatment landscape of multiple myeloma has changed over the past several years with the development and approval of several new therapies. Therapies including CD38 monoclonal antibodies and immunotherapy in the form of both CAR T and bispecific T cell engagers have changed the management of relapsed and refractory multiple myeloma.  Despite these new therapies, multiple myeloma is still considered to be an incurable hematologic malignancy. Recent and ongoing clinical trials have evaluated these therapies in earlier lines and looked to define the optimal sequencing of treatments.

For example, CD38 antibodies have been used in combinations in both transplant eligible and ineligible patients in the frontline setting resulting in improved efficacy. This shift in management, in turn, has altered second-line treatment and beyond. As more patients are treated with immunotherapies earlier in their disease course, the management and prevention of complications related to treatment needs to be considered in the overall management of multiple myeloma.

This Special Issue will address the most recent and relevant scientific findings regarding frontline treatment, treatment of relapsed refractory multiple myeloma, and optimal sequencing of therapies. In addition, the Special Issue will also address the management of toxicities specific to these emerging treatments.

Dr. Terri Parker
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 250 words) can be sent to the Editorial Office for assessment.

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-anonymized 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
  • frontline treatment
  • monoclonal antibodies
  • sequencing of treatment
  • immunotherapy
  • CAR T
  • Bi-specific T cell engagers
  • toxicity management

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (3 papers)

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Research

14 pages, 2244 KB  
Article
Factors Affecting Prognosis in Patients with Extramedullary Myeloma: A Single-Center Experience
by Ersin Bozan, Samet Yaman, Gökcen Bozan, Mahmut Esad Durmuş, Burcu Aslan Candır, Uğur Hatipoğlu, Barış Boral, Dicle İskender, Bahar Uncu Ulu, Tuğçe Nur Yiğenoğlu, Mehmet Sinan Dal and Fevzi Altuntaş
J. Clin. Med. 2026, 15(17), 6765; https://doi.org/10.3390/jcm15176765 - 31 Aug 2026
Viewed by 217
Abstract
Background/Objectives: In multiple myeloma, extramedullary involvement confers poor prognosis. Extramedullary involvement in multiple myeloma may manifest at the time of diagnosis or during a relapse, and it represents a severe condition. Patients with bone involvement are referred to as EM-B, while those [...] Read more.
Background/Objectives: In multiple myeloma, extramedullary involvement confers poor prognosis. Extramedullary involvement in multiple myeloma may manifest at the time of diagnosis or during a relapse, and it represents a severe condition. Patients with bone involvement are referred to as EM-B, while those with soft tissue involvement are referred to as EM-S. Although various studies have been conducted, the number of studies that categorize extramedullary involvement and examine the effects of flow cytometry, treatment, and genetic findings on prognosis is quite limited. We aimed to contribute to the literature by addressing this gap. Methods: In our study, we retrospectively examined the data of 281 patients followed at our center between 2011 and 2023. Clinical/laboratory data and flow cytometry profiles were collected. Survival was analyzed using Kaplan–Meier and Cox models; logistic regression was used for categorical variables. Hazard ratios (HRs), odds ratios (ORs), and 95% confidence intervals (CIs) were calculated; p-values were reported to three decimals. Results: Extramedullary involvement was absent in 134 (47.7%) patients, while involvement was detected in 147 (52.3%) patients. The median age of the patients was 60 years, and the median follow-up period was 35.4 months. No association was found between CD56 expression on plasma cells, higher Revised Multiple Myeloma International Staging System (R-ISS) score, and extramedullary involvement. Overall survival (OS) was found to be significantly lower in patients with extramedullary involvement. Conclusions: The findings of our study are consistent with many studies in the literature, supporting the finding that survival rates are lower in myeloma patients with extramedullary involvement. Further studies are needed to elucidate the pathogenesis in patients with extramedullary involvement in multiple myeloma and to provide a basis for targeted therapies. Studies involving immunotherapy and cellular therapies may offer a new avenue for these patients. Full article
(This article belongs to the Special Issue Multiple Myeloma: Therapeutic and Management Strategies)
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12 pages, 331 KB  
Article
The Role of Therapeutic Plasma Exchange in the Management of Myeloma-Related Cast Nephropathy: A 10-Year Real-World Cohort Study
by Hasan Salur, Unal Atas, Nurcan Alhan, Ece Vural, Utku Iltar, Orhan Kemal Yucel and Ozan Salim
J. Clin. Med. 2026, 15(2), 417; https://doi.org/10.3390/jcm15020417 - 6 Jan 2026
Cited by 1 | Viewed by 1335
Abstract
Background: Renal impairment is a frequent and severe complication of multiple myeloma, most commonly caused by light-chain cast nephropathy. Therapeutic plasma exchange (TPE) has been proposed as an adjunctive approach to rapidly reduce circulating free light chains; however, its clinical benefit remains controversial. [...] Read more.
Background: Renal impairment is a frequent and severe complication of multiple myeloma, most commonly caused by light-chain cast nephropathy. Therapeutic plasma exchange (TPE) has been proposed as an adjunctive approach to rapidly reduce circulating free light chains; however, its clinical benefit remains controversial. Methods: We retrospectively analyzed 71 patients treated between 2013 and 2023, of whom 30 received TPE in addition to anti-myeloma therapy and 41 received anti-myeloma therapy alone. Renal outcomes were assessed within a predefined early treatment window encompassing the first 4–6 cycles of therapy. Renal response was defined as a ≥50% reduction in serum creatinine and/or dialysis independence. Multivariable logistic regression and sensitivity analyses were performed to adjust for baseline imbalances, including renal function and anti-myeloma backbone therapy. Results: Although renal function improved significantly over time in both groups, renal response rates were comparable between patients treated with and without TPE (40% vs. 36.6%). In multivariable analysis, TPE was not independently associated with renal response. Importantly, in a sensitivity analyses restricted to patients receiving bortezomib-based regimens, the addition of TPE remained unassociated with improved renal outcomes. Conclusions: In this real-world cohort, adjunctive TPE did not confer a significant advantage in renal recovery or dialysis independence beyond contemporary anti-myeloma therapy. These findings indicate that renal recovery is predominantly driven by effective anti-myeloma treatment rather than extracorporeal light-chain removal. Full article
(This article belongs to the Special Issue Multiple Myeloma: Therapeutic and Management Strategies)
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12 pages, 696 KB  
Article
The Impact of Endothelial Cell Values in Bone Marrow on the Survival of Patients with Multiple Myeloma—A Single-Center Observational Study
by Krzysztof Gawroński, Nadia Hussein, Elżbieta Rutkowska, Iwona Kwiecień, Agata Raniszewska, Katarzyna Gawrońska and Piotr Rzepecki
J. Clin. Med. 2025, 14(19), 6710; https://doi.org/10.3390/jcm14196710 - 23 Sep 2025
Cited by 1 | Viewed by 915
Abstract
Background: This study aimed to analyze the survival of patients with multiple myeloma in relation to the value of endothelial cells involved in the process of tumor neoangiogenesis. Methods: In this non-randomized observational study, we prospectively evaluated a cohort of 74 adult patients [...] Read more.
Background: This study aimed to analyze the survival of patients with multiple myeloma in relation to the value of endothelial cells involved in the process of tumor neoangiogenesis. Methods: In this non-randomized observational study, we prospectively evaluated a cohort of 74 adult patients with multiple myeloma who underwent a baseline assessment of the endothelial cell count in their bone marrow and received VCD or VTD anti-myeloma therapy followed by autoPBSCT. They were then evaluated for survival via long-term follow-up. Results: The survival of myeloma patients undergoing these therapies was analyzed, and we found that patients with higher endothelial cell counts had higher mortality rates during long-term follow-up. In the group of patients who died, the endothelial cell count was significantly higher (p = 0.024). We also observed that patients who initially had >2 osteolytic lesions had higher endothelial cell counts (p = 0.021). However, our analysis of endothelial cell count in relation to patient survival using antiangiogenic drugs showed that, in this group, the endothelial cell count was significantly higher in patients who died (p = 0.048). Conclusions: We found that patients with higher endothelial cell counts and those who did not receive antiangiogenic drugs from the start of therapy had higher mortality rates during long-term follow-up. Full article
(This article belongs to the Special Issue Multiple Myeloma: Therapeutic and Management Strategies)
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