What’s New for Multiple Myeloma Patients in the UAE? Discover the Latest Treatments, Improved Survival Rates, and What You Can Access in 2025

This article outlines standards of care, recent therapeutic advancements, eligibility factors, treatment processes, and patient support relevant to myeloma management in the UAE.

Modern Myeloma Diagnosis and Initial Assessment

Diagnosis of myeloma in the UAE is consistent with international guidelines, requiring the identification of at least 10% clonal plasma cells in the bone marrow together with organ impairment (such as hypercalcemia, renal dysfunction, anemia, or bone lesions—referred to as “CRAB” symptoms). Patients undergo testing that includes cytogenetic risk assessment, evaluation of kidney function, and frailty scoring to guide treatment strategies, including the potential for stem cell transplantation or selection of induction chemotherapy.

State-of-the-Art First-Line Therapy in 2025

For Transplant-Eligible Patients

Quadruplet Therapy and ASCT
For newly diagnosed, transplant-eligible patients (with a median age at diagnosis around 43 in the UAE), a quadruplet regimen is recommended according to the latest international and regional guidance:

• Daratumumab, Bortezomib, Lenalidomide, and Dexamethasone (Dara-VRd)
  • The protocol consists of four induction cycles pre-ASCT, two consolidation cycles after the transplant, and then maintenance therapy.
  • Maintenance generally involves lenalidomide or, in selected patients, daratumumab-lenalidomide until disease progression or intolerance.

Transplantation Process
Since 2021, comprehensive hematopoietic stem cell transplantation services are available locally in the UAE (such as at Burjeel Medical City, Abu Dhabi).

• Key steps:
  • Hematopoietic stem cells are mobilized and collected for transplantation;
  • High-dose melphalan is used for conditioning;
  • Stem cells are reinfused and monitored with advanced laboratory tools, including minimal residual disease (MRD) flow cytometry.
• Outcomes (UAE data 2023-2024):
  • 2-year overall survival: 97%
  • 2-year progression-free survival: 81%
  • Engraftment and infection management outcomes consistent with data from leading international centers.

For Transplant-Ineligible Patients

For patients who are not candidates for ASCT, due to age, comorbidities, or frailty, treatment emphasizes balancing efficacy and quality of life:

• Daratumumab, Lenalidomide, and Dexamethasone (Dara-Rd) is used as the main regimen.
  • Therapy continues until progression or unacceptable toxicity.
  • The MAIA clinical trial reported a median progression-free survival up to 62 months.
  • Selected fit elderly patients may receive quadruplet therapy (Dara-VRd or isatuximab-VRd), supported by global clinical trial evidence (e.g., IMROZ, CEPHEUS).

Approaches for High-Risk or Renal-Impaired Patients

• For high-risk cytogenetics: Quadruplet induction (Dara-VRd or Isa-KRd) and, in some cases, tandem ASCT can be considered.
• For patients with renal dysfunction: Lenalidomide may be substituted with cyclophosphamide (e.g., Dara-VCd), as indicated in clinical guidance.

Recent Advancements in Myeloma Therapeutics

Monoclonal Antibodies in Care

• Daratumumab and isatuximab (both CD38-targeted therapies) are part of standard protocols for both initial and relapsed disease.
• Subcutaneous daratumumab is preferred for many, offering monthly administration and lower rates of infusion reactions.

Adapting Dosing to Patient Needs

• Adjusted dosing schedules, such as weekly bortezomib, are commonly used to reduce the risk of neuropathy, especially in older or frail individuals.
• Treatment protocols can be further adapted for patients with specific side effects or organ impairment.

MRD-Guided and Maintenance Therapy

• MRD (Minimal Residual Disease) testing with in-house flow cytometry is used in UAE centers to guide decisions about maintenance therapy duration and intensity.

Guideline and Regulatory Updates

• The latest NCCN updates (September 2024) and new FDA approvals endorse VRd-based quadruplets for transplant-eligible and ineligible patients, with isatuximab or daratumumab additions showing incremental benefit in recent trials (PERSEUS, IMROZ, CEPHEUS).

Supportive Care

Supportive measures are integrated throughout myeloma care in 2025:

• Bone health: Bisphosphonates and RANK ligand inhibitors for skeletal support.
• Infection prevention: Intravenous immunoglobulin may be used in selected patients with hypogammaglobulinemia.
• Anticoagulation: Preventive treatment against thrombosis, especially with immunomodulatory drugs.
• Gastrointestinal support: Specific agents as needed to manage side effects.

This multifaceted approach is intended to enhance patients’ ability to continue therapy, with the aim of improving tolerability and outcomes.

Access, Costs, and Systemic Considerations

Insurance and Referral Processes

• ASCT and advanced therapies (including monoclonal antibodies and quadruplet regimens) are usually covered under premium-tier insurance plans in the UAE.
• Approval by insurers and timely referral pathways are important to avoid delays, as these can impact the timeliness of starting therapy.
• Ongoing efforts by local clinicians and patient advocates are focused on expanding coverage accessibility and streamlining communication.

Cost Factors

• While specific patient-level costs are not openly published, it is widely recognized that these therapies and procedures represent a significant medical expense. Access is often associated with comprehensive insurance coverage.
• Patients and their families are encouraged to clarify insurance benefits with their healthcare providers and insurers early, to anticipate any potential delays or out-of-pocket costs.

Clinical Trials and Ongoing Research

• UAE treatment centers are active in international clinical trials—for example, those involving the CEPHEUS and IMROZ protocols.
• Investigational therapies such as iberdomide and other novel immunotherapies are under study, with some opportunities for local patient enrollment.
• Emerging strategies involving MRD-guided therapy may inform the duration of treatment and next steps as data become available.

Patient Support and Resources

• As of 2025, formal psychosocial support and dedicated patient advocacy programs specific to myeloma in the UAE are limited, though hospital-based hemato-oncology centers commonly provide nurse navigators, social worker consultations, and guidance on available resources.
• Expansion of comprehensive patient support and advocacy remains an area for future development.

As of 2025, people living with multiple myeloma in the UAE can access therapies that align with international best practices, including quadruplet regimens, stem cell transplantation, and new antibody-based treatments, complemented by laboratory and supportive care services. Approaches are increasingly personalized based on patient characteristics and response. For current options and details on coverage or supportive care, patients should consult with their treating hematologist.

Sources

• Frontline management of multiple myeloma patients: optimizing treatment for patients in the Gulf region
• Paving the Road for Haematopoietic Stem Cell Transplantation in the United Arab Emirates: A Single Centre’s Experience
• Updates to NCCN Guidelines for Multiple Myeloma: Recently Approved First-Line Treatments for Patients With NDMM Eligible and Ineligible for Transplant

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