Khashayar Alikarami - Student Research Committee of Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Mohammad Amin Dehghani - Student Research Committee of Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Golnoosh Alikarami - School of Medicine, Hamedan University of Medical Sciences, Hamedan, Iran
Fatemeh Dehghani - Department of Genetics, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

Background & Objectives: Multiple myeloma (MM) is established in the skeleton as a plasma cell cancer, causing bone destruction and reflective fractures. Generally, MM is the main cause of 10% of hematologic malignancies. Nonetheless, immunomodulatory drugs (IMiDs) and proteasome inhibitors have considerably modified the control of MM. The IMiDs encompassing thalidomide, lenalidomide, and pomalidomide has greatly contributed to the treatment of patients with MM.Materials and Methods: In this study, English articles related to our subject were found on PubMed database using the keywords of pomalidomide, IMiDs, lenalidomide, clinical treatment, multiple myeloma, and thalidomide.Results: Extreme toxicity can be caused in old sick people by thalidomide, which is a first generation IMiD. Lenalidomide has less side effects and is recognized as a more efficient second generation IMiD, compared to thalidomide. In addition, lenalidomide is applied as maintenance therapy after relapsed refractory myeloma and autologous stem cell transplantation (ASCT). With a 10-fold higher power, compared to lenalidomide, pomalidomide is a third generation IMiD and has significant effects on patients with MM, who had a relapse. Today, there is a lower consumption of thalidomide in the relapsed/refractory setting, whereas pomalidomide is currently applied. In addition to relapsed/refractory setting and the maintenance setting post-transplant, lenalidomide is extensively exploited in treatment of patients who are both transplant-ineligible and transplant-eligible. Conclusion: According to the results of the study, the clinical application of IMiDs in MM can result in a significant improvement in long-term survival and life quality of patients. It is suggested that future studies be carried out to identify novel biomarkers with the ability of predicting MM results and new combinations of lenalidomide and pomalidomde with PI monoclonal antibodies, immune checkpoint blockers and several other types of chemotherapies.

Thalidomide, Multiple Myeloma, lenalidomide, IMiDs, Clinical Treatment, Pomalidomide