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MULTIPLE MYELOMA
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Multiple myeloma is a bone marrow disease characterized by the presence of malignant plasma cells, & abnormal serum &/or urine immunoglobulin secondary to clonal plasma cell expansion.

It accounts for 1-2% of all cancers worldwide & mostly affects patients at ages 65-74 years old.

Patient usually presents with bone pain & nonspecific symptoms, or due to abnormalities in laboratory exams.

 

Multiple Myeloma References

  1. Anderson K, Ismaila N, Flynn PJ, et al. Role of bone-modifying agents in multiple myeloma: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2018 Mar;36(8):812-818. doi: 10.1200/JCO.2017.76.6402. PMID: 29341831
  2. Cavo M, Rajkumar SV, Palumbo A, et al; International Myeloma Working Group. International Myeloma Working Group consensus approach to the treatment of multiple myeloma patients who are candidates for autologous stem cell transplantation. Blood. 2011 Jun;117(23):6063-6073. doi: 10.1182/blood-2011-02-297325. PMID: 2144782
  3. International Myeloma Working Group. International Myeloma Working Group (IMWG) molecular classification of multiple myeloma. IMWG. http://imwg.myeloma.org/. Jul 2010.
  4. International Myeloma Working Group. International Myeloma Working Group (IMWG) criteria for the diagnosis of multiple myeloma. IMWG. http://imwg.myeloma.org/. Oct 2015.
  5. Kumar S, Paiva B, Anderson KC, et al. International Myeloma Working Group consensus criteria for response and minimal residual disease assessment in multiple myeloma. Lancet Oncol. 2016 Aug;17(8):e328-e346. doi: 10.1016/S1470-2045(16)30206-6. PMID: 27511158
  6. Medical Scientific Advisory Group (MSAG) to the Myeloma Foundation of Australia. Clinical practice guidelines: Multiple myeloma. Myeloma Foundation of Australia Inc. http://myeloma.org.au/. Mar 2017.
  7. Michels TC, Petersen KE. Multiple myeloma: Diagnosis and treatment. Am Fam Physician. 2017 Mar;95(6):373-383. PMID: 28318212
  8. Moreau P, San Miguel J, Sonneveld P, et al; ESMO Guidelines Committee. Multiple myeloma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2017 Jul;28(Suppl 4):iv52-iv61. doi: 10.1093/annonc/mdx096. PMID: 28453614
  9. National Comprehensive Cancer Network. Multiple myeloma: version 1.2019. NCCN. https://www.nccn.org/. 20 Jul 2018.
  10. National Comprehensive Cancer Network. Multiple myeloma: version 4.2018. NCCN. https://www.nccn.org/. 2018.
  11. Ocio EM, Richardson PG, Rajkumar SV, et al. New drugs and novel mechanisms of action in multiple myeloma in 2013: a report from the International Myeloma Working Group (IMWG). Leukemia. 2014 Mar;28(3):525-542. doi: 10.1038/leu.2013.350. PMID: 24253022
  12. Palumbo A, Avet-Loiseau H, Oliva S, et al. Revised International Staging System for Multiple Myeloma: A report from International Myeloma Working Group. J Clin Oncol. 2015 Sep;33(26):2863-2869. doi: 10.1200/JCO.2015.61.2267. PMID: 26240224
  13. Rajkumar SV, Dimopoulos MA, Palumbo A, et al. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol. 2014 Nov;15(12):e538-e548. doi: 10.1016/S1470-2045(14)70442-5. PMID: 25439696
  14. Rajkumar SV. Clinical features, laboratory manifestations, and diagnosis of multiple myeloma. UptoDate. https://www.uptodate.com. Feb 2018.
  15. Rajkumar SV. Multiple myeloma: overview of management. UpToDate. https://www.uptodate.com. 10 Aug 2020. Accessed 11 May 2018.
  16. Rajkumar SV. Pathobiology of multiple myeloma. UptoDate. https://www.uptodate.com. Nov 2017.
  17. Rajkumar SV. Multiple myeloma: treatment of relapsed or refractory disease. UpToDate. https://www.uptodate.com. 25 Aug 2020. Accessed 11 May 2018.
  18. Tan D, Chng WJ, Chou T, et al. Management of multiple myeloma in Asia: resource-stratified guidelines. Lancet Oncol. 2013 Nov;14(12):e571-e581. doi: 10.1016/S1470-2045(13)70404-2. PMID: 24176575
  19. Terpos E, Kleber M, Engelhardt M, et al; European Myeloma Network. European Myeloma Network guidelines for the management of multiple myeloma-related complications. Haematologica. 2015 Oct;100(10):1254-1266. doi: 10.3324/haematol.2014.117176. PMID: 26432383
  20. Watson HG, Craig JIO, Manson LM. Blood disease. In: Walker BR, Colledge NR, Ralston SH, Penman ID. Davidson’s Principles and Practice of Medicine. 12th ed. Philadelphia, PA: Churchill Livingstone Elsevier; 2014.
  21. de Mel S, Chen Y, Gopalakrishnan SK, et al. The Singapore Myeloma Study Group Consensus Guidelines for the management of patients with multiple myeloma. Singapore Med J. 2017 Feb;58(2):55-71. doi: 10.11622/smedj.2016150. PMID: 27609508
  22. Hillengass J, Usmani S, Rajkumar SV, et al. International myeloma working group consensus recommendations on imaging in monoclonal plasma cell disorders. Lancet Oncol. 2019 Jun;20(6):e302-e312. doi: 10.1016/S1470-2045(19)30309-2. PMID: 31162104
  23. Mikhael J, Ismaila N, Cheung MC, et al. Treatment of multiple myeloma: ASCO and CCO joint clinical practice guideline. J Clin Oncol. 2019 May;37(14):1228-1263. doi: 10.1200/JCO.18.02096. PMID: 30932732
  24. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: Multiple myeloma. Version 2.2020. NCCN. https://www.nccn.org/. Oct 2019.
  25. National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology: Multiple myeloma. Version 3.2020. NCCN. https://www.nccn.org/. Mar 2020.
  26. National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology: Multiple myeloma. Version 4.2020. NCCN. https://www.nccn.org/. May 2020.
  27. National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology (NCCN guidelines): Multiple myeloma. Version 3.2021. NCCN. https://www.nccn.org/. 19 Oct 2020.
  28. Bergstrom DJ, Kotb R, Louzada ML, et al. Consensus guidelines on the diagnosis of multiple myeloma and related disorders: recommendations of the Myeloma Canada Research Network Consensus Guidelines Consortium. Clin Lymphoma Myeloma Leuk. 2020 Jul;20(7):e352-e367. doi: 10.1016/j.clml.2020.01.017. PMID: 32249195
  29. Cancer Therapy Advisor. Multiple myeloma treatment regimens. Cancer Therapy Advisor. https://www.cancertherapyadvisor.com/. Oct 2017.
  30. Rajkumar SV. Multiple myeloma: regimens used for relapsed or refractory disease. UpToDate. https://www.uptodate.com. 25 Aug 2020.
  31. Rajkumar SV. Multiple myeloma: selection of initial chemotherapy for symptomatic disease. UpToDate. https://www.uptodate.com. 02 Oct 2020.
  32. Laubach JP. Multiple myeloma: clinical features, laboratory manifestations, and diagnosis. UpToDate. https://www.uptodate.com. 13 Aug 2020.
  33. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: Multiple myeloma. Version 7.2021. NCCN. https://www.nccn.org/. 26 Apr 2021.
  34. National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology: Multiple myeloma. Version 1.2022. NCCN. https://www.nccn.org/. 16 Aug 2021.
  35. Dimopoulos MA, Moreau P, Terpos E, et al; EHA Guidelines Committee; ESMO Guidelines Committee. Multiple myeloma: EHA-ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up†. Ann Oncol. 2021 Mar;32(3):309-322. doi: 10.1016/j.annonc.2020.11.014. PMID: 33549387
  36. National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncology (NCCN guidelines): Multiple myeloma. Version 4.2022. NCCN. https://www.nccn.org/. Dec 2021.
  37. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology (NCCN guidelines): Multiple myeloma. Version 5.2022. NCCN. https://www.nccn.org/. Mar 2022.
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