Multiple myeloma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

P. Moreau, J. San Miguel, P. Sonneveld, M. V. Mateos, E. Zamagni, H. Avet-Loiseau, R. Hajek, M. A. Dimopoulos, H. Ludwig, H. Einsele, S. Zweegman, T. Facon, M. Cavo, E. Terpos, H. Goldschmidt, M. Attal, C. Buske, on behalf of the ESMO Guidelines Committee

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

These Clinical Practice Guidelines are endorsed by the Japanese Society of Medical Oncology (JSMO) incidence and epidemiology Multiple myeloma (MM) accounts for 1% of all cancers and ∼10% of all haematological malignancies. The incidence in Europe is 4.5–6.0/100 000/year with a median age at diagnosis of between 65 and 70 years; the mortality is 4.1/100 000/year. Almost all patients with MM evolve from an asymptomatic pre-malignant stage termed monoclonal gammopathy of undetermined significance (MGUS). MGUS progresses to MM at a rate of 1% per year. In some patients, an intermediate asymptomatic but more advanced pre-malignant stage termed smouldering (or indolent) multiple myeloma (SMM) can be recognised. SMM progresses to myeloma at a rate of 10% per year over the first 5 years following diagnosis, 3% per year over the following 5 years and 1.5% per year thereafter [1]. diagnosis Diagnosis of MM should be based on the following tests: [1] -Detection and evaluation of the monoclonal (M-) component by serum and/or urine protein electrophoresis (concentrate of 24 h urine collection); nephelometric quantification of IgG, IgA and IgM immunoglobulins; characterisation of the heavy and light chains by immunofixation; and serum-free light-chain (FLC) measurement; -Evaluation of bone marrow (BM) plasma cell infiltration: BM aspiration and/or biopsies are the standard options to evaluate the number and characteristics. Moreover, the BM sample should be used for cytogenetic/fluorescence in situ hybridization (FISH) studies and also has the potential for immunophenotypic and molecular investigations; -Evaluation of lytic bone lesions: a radiological skeletal bone survey, including spine, pelvis, skull, humeri and femurs is necessary. A magnetic resonance imaging (MRI) or computed tomography (CT) scan may be needed to evaluate symptomatic bony sites, even if the skeletal survey is negative and the patient has symptoms suggesting bone lesions. Moreover, MRI provides greater detail and is recommended whenever spinal cord compression is suspected. Fluorodeoxyglucose positron emission tomography is currently under evaluation but should not be systematically used; -Complete blood cell count, with differential serum creatinine and calcium level.
Original languageEnglish
Pages (from-to)iv52-iv61
JournalAnnals of Oncology
Volume28
DOIs
Publication statusPublished - 2017

Cite this

Moreau, P., San Miguel, J., Sonneveld, P., Mateos, M. V., Zamagni, E., Avet-Loiseau, H., ... on behalf of the ESMO Guidelines Committee (2017). Multiple myeloma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology, 28, iv52-iv61. https://doi.org/10.1093/annonc/mdx096
Moreau, P. ; San Miguel, J. ; Sonneveld, P. ; Mateos, M. V. ; Zamagni, E. ; Avet-Loiseau, H. ; Hajek, R. ; Dimopoulos, M. A. ; Ludwig, H. ; Einsele, H. ; Zweegman, S. ; Facon, T. ; Cavo, M. ; Terpos, E. ; Goldschmidt, H. ; Attal, M. ; Buske, C. ; on behalf of the ESMO Guidelines Committee. / Multiple myeloma : ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. In: Annals of Oncology. 2017 ; Vol. 28. pp. iv52-iv61.
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abstract = "These Clinical Practice Guidelines are endorsed by the Japanese Society of Medical Oncology (JSMO) incidence and epidemiology Multiple myeloma (MM) accounts for 1{\%} of all cancers and ∼10{\%} of all haematological malignancies. The incidence in Europe is 4.5–6.0/100 000/year with a median age at diagnosis of between 65 and 70 years; the mortality is 4.1/100 000/year. Almost all patients with MM evolve from an asymptomatic pre-malignant stage termed monoclonal gammopathy of undetermined significance (MGUS). MGUS progresses to MM at a rate of 1{\%} per year. In some patients, an intermediate asymptomatic but more advanced pre-malignant stage termed smouldering (or indolent) multiple myeloma (SMM) can be recognised. SMM progresses to myeloma at a rate of 10{\%} per year over the first 5 years following diagnosis, 3{\%} per year over the following 5 years and 1.5{\%} per year thereafter [1]. diagnosis Diagnosis of MM should be based on the following tests: [1] -Detection and evaluation of the monoclonal (M-) component by serum and/or urine protein electrophoresis (concentrate of 24 h urine collection); nephelometric quantification of IgG, IgA and IgM immunoglobulins; characterisation of the heavy and light chains by immunofixation; and serum-free light-chain (FLC) measurement; -Evaluation of bone marrow (BM) plasma cell infiltration: BM aspiration and/or biopsies are the standard options to evaluate the number and characteristics. Moreover, the BM sample should be used for cytogenetic/fluorescence in situ hybridization (FISH) studies and also has the potential for immunophenotypic and molecular investigations; -Evaluation of lytic bone lesions: a radiological skeletal bone survey, including spine, pelvis, skull, humeri and femurs is necessary. A magnetic resonance imaging (MRI) or computed tomography (CT) scan may be needed to evaluate symptomatic bony sites, even if the skeletal survey is negative and the patient has symptoms suggesting bone lesions. Moreover, MRI provides greater detail and is recommended whenever spinal cord compression is suspected. Fluorodeoxyglucose positron emission tomography is currently under evaluation but should not be systematically used; -Complete blood cell count, with differential serum creatinine and calcium level.",
author = "P. Moreau and {San Miguel}, J. and P. Sonneveld and Mateos, {M. V.} and E. Zamagni and H. Avet-Loiseau and R. Hajek and Dimopoulos, {M. A.} and H. Ludwig and H. Einsele and S. Zweegman and T. Facon and M. Cavo and E. Terpos and H. Goldschmidt and M. Attal and C. Buske and {on behalf of the ESMO Guidelines Committee}",
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Moreau, P, San Miguel, J, Sonneveld, P, Mateos, MV, Zamagni, E, Avet-Loiseau, H, Hajek, R, Dimopoulos, MA, Ludwig, H, Einsele, H, Zweegman, S, Facon, T, Cavo, M, Terpos, E, Goldschmidt, H, Attal, M, Buske, C & on behalf of the ESMO Guidelines Committee 2017, 'Multiple myeloma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up' Annals of Oncology, vol. 28, pp. iv52-iv61. https://doi.org/10.1093/annonc/mdx096

Multiple myeloma : ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. / Moreau, P.; San Miguel, J.; Sonneveld, P.; Mateos, M. V.; Zamagni, E.; Avet-Loiseau, H.; Hajek, R.; Dimopoulos, M. A.; Ludwig, H.; Einsele, H.; Zweegman, S.; Facon, T.; Cavo, M.; Terpos, E.; Goldschmidt, H.; Attal, M.; Buske, C.; on behalf of the ESMO Guidelines Committee.

In: Annals of Oncology, Vol. 28, 2017, p. iv52-iv61.

Research output: Contribution to journalArticleAcademicpeer-review

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T2 - ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

AU - Moreau, P.

AU - San Miguel, J.

AU - Sonneveld, P.

AU - Mateos, M. V.

AU - Zamagni, E.

AU - Avet-Loiseau, H.

AU - Hajek, R.

AU - Dimopoulos, M. A.

AU - Ludwig, H.

AU - Einsele, H.

AU - Zweegman, S.

AU - Facon, T.

AU - Cavo, M.

AU - Terpos, E.

AU - Goldschmidt, H.

AU - Attal, M.

AU - Buske, C.

AU - on behalf of the ESMO Guidelines Committee

PY - 2017

Y1 - 2017

N2 - These Clinical Practice Guidelines are endorsed by the Japanese Society of Medical Oncology (JSMO) incidence and epidemiology Multiple myeloma (MM) accounts for 1% of all cancers and ∼10% of all haematological malignancies. The incidence in Europe is 4.5–6.0/100 000/year with a median age at diagnosis of between 65 and 70 years; the mortality is 4.1/100 000/year. Almost all patients with MM evolve from an asymptomatic pre-malignant stage termed monoclonal gammopathy of undetermined significance (MGUS). MGUS progresses to MM at a rate of 1% per year. In some patients, an intermediate asymptomatic but more advanced pre-malignant stage termed smouldering (or indolent) multiple myeloma (SMM) can be recognised. SMM progresses to myeloma at a rate of 10% per year over the first 5 years following diagnosis, 3% per year over the following 5 years and 1.5% per year thereafter [1]. diagnosis Diagnosis of MM should be based on the following tests: [1] -Detection and evaluation of the monoclonal (M-) component by serum and/or urine protein electrophoresis (concentrate of 24 h urine collection); nephelometric quantification of IgG, IgA and IgM immunoglobulins; characterisation of the heavy and light chains by immunofixation; and serum-free light-chain (FLC) measurement; -Evaluation of bone marrow (BM) plasma cell infiltration: BM aspiration and/or biopsies are the standard options to evaluate the number and characteristics. Moreover, the BM sample should be used for cytogenetic/fluorescence in situ hybridization (FISH) studies and also has the potential for immunophenotypic and molecular investigations; -Evaluation of lytic bone lesions: a radiological skeletal bone survey, including spine, pelvis, skull, humeri and femurs is necessary. A magnetic resonance imaging (MRI) or computed tomography (CT) scan may be needed to evaluate symptomatic bony sites, even if the skeletal survey is negative and the patient has symptoms suggesting bone lesions. Moreover, MRI provides greater detail and is recommended whenever spinal cord compression is suspected. Fluorodeoxyglucose positron emission tomography is currently under evaluation but should not be systematically used; -Complete blood cell count, with differential serum creatinine and calcium level.

AB - These Clinical Practice Guidelines are endorsed by the Japanese Society of Medical Oncology (JSMO) incidence and epidemiology Multiple myeloma (MM) accounts for 1% of all cancers and ∼10% of all haematological malignancies. The incidence in Europe is 4.5–6.0/100 000/year with a median age at diagnosis of between 65 and 70 years; the mortality is 4.1/100 000/year. Almost all patients with MM evolve from an asymptomatic pre-malignant stage termed monoclonal gammopathy of undetermined significance (MGUS). MGUS progresses to MM at a rate of 1% per year. In some patients, an intermediate asymptomatic but more advanced pre-malignant stage termed smouldering (or indolent) multiple myeloma (SMM) can be recognised. SMM progresses to myeloma at a rate of 10% per year over the first 5 years following diagnosis, 3% per year over the following 5 years and 1.5% per year thereafter [1]. diagnosis Diagnosis of MM should be based on the following tests: [1] -Detection and evaluation of the monoclonal (M-) component by serum and/or urine protein electrophoresis (concentrate of 24 h urine collection); nephelometric quantification of IgG, IgA and IgM immunoglobulins; characterisation of the heavy and light chains by immunofixation; and serum-free light-chain (FLC) measurement; -Evaluation of bone marrow (BM) plasma cell infiltration: BM aspiration and/or biopsies are the standard options to evaluate the number and characteristics. Moreover, the BM sample should be used for cytogenetic/fluorescence in situ hybridization (FISH) studies and also has the potential for immunophenotypic and molecular investigations; -Evaluation of lytic bone lesions: a radiological skeletal bone survey, including spine, pelvis, skull, humeri and femurs is necessary. A magnetic resonance imaging (MRI) or computed tomography (CT) scan may be needed to evaluate symptomatic bony sites, even if the skeletal survey is negative and the patient has symptoms suggesting bone lesions. Moreover, MRI provides greater detail and is recommended whenever spinal cord compression is suspected. Fluorodeoxyglucose positron emission tomography is currently under evaluation but should not be systematically used; -Complete blood cell count, with differential serum creatinine and calcium level.

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Moreau P, San Miguel J, Sonneveld P, Mateos MV, Zamagni E, Avet-Loiseau H et al. Multiple myeloma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2017;28:iv52-iv61. https://doi.org/10.1093/annonc/mdx096