Frontline management of transplant-ineligible newly diagnosed multiple myeloma (TINDMM) in Canada


  • Christopher Venner, MD, FRCPC
  • Julia Varghese, MD, FRCPC



Multiple myeloma (MM) is a hematologic malignancy characterized by clonal proliferation of plasma cells in the bone marrow leading to end organ dysfunction including hypercalcemia, anemia, renal dysfunction, and/or bony lytic lesions. The median age of diagnosis is 69 years of age with approximately one-third of newly diagnosed patients presenting over age 75. Therefore, a significant portion of patients presenting with newly diagnosed MM are considered ineligible for transplant due to chronological age, comorbidities or frailty. This category represents a largely heterogeneous group of patients. With options for frontline management rapidly changing, practitioners must consider the optimal treatment modality.

Author Biographies

Christopher Venner, MD, FRCPC

Dr. Chris Venner completed his medical training at the University of Calgary and the University of Alberta. He later attended the University of British Columbia to complete a sub-specialty degree in Hematology. He then went on to pursue a Plasma Cell Dyscrasias Fellowship jointly through the Leukemia/Bone Marrow Transplant Program of British Columbia, St. Bartholomew’s Hospital and the London School of Medicine and the National Amyloidosis Centre. He subsequently joined the National Amyloid Centre as a staff physician before returning to Edmonton and the Cross Cancer Institute and led the Malignant Hematology Program and the Myeloma/Plasma Cell Dyscrasias group. In 2021 he joined the BC Cancer – Vancouver Centre to advance the Plasma Cell Dyscrasias Program. In addition to being actively involved in hematology clinical trials, his current academic interest involves clinical outcomes research in plasma cell dyscrasias, examining the evolution of therapy in these diseases and the impact novel combinations have on survival. Much of this work is done through the Canadian Myeloma Research Group through activities in the CMRG Canadian Multiple Myeloma Database initiative which he led as Chair (2014-2021), and the CMRG clinical trials group. He is also the Co-Chair of the Myeloma Sub-Committee with the Canadian Cancer Trials Group.

Julia Varghese, MD, FRCPC

Dr. Julia Varghese is a hematologist in Vancouver, BC. She obtained her MD through the University of British Columbia’s Northern Medical Program and completed both her Internal Medicine and Hematology training at UBC. She is currently completing a Myeloma fellowship at the British Columbia Cancer Agency (Vancouver site) under the mentorship of Dr. Christopher Venner.


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How to Cite

Venner C, Varghese J. Frontline management of transplant-ineligible newly diagnosed multiple myeloma (TINDMM) in Canada. Can Hematol Today [Internet]. 2023 Mar. 1 [cited 2023 Sep. 29];2(1):5–9. Available from:




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