Management of Newly Diagnosed Symptomatic Multiple Myeloma: Updated Mayo Stratification of Myeloma and Risk-Adapted Therapy (mSMART) Consensus Guidelines 2013

Abstract Multiple myeloma remains an incurable neoplasm of plasma cells that affects more than 20,000 people annually in the United States. There has been a veritable revolution in this disease during the past decade, with dramatic improvements in our understanding of its pathogenesis, the developme...

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Veröffentlicht in:	Mayo Clinic proceedings 2013-04, Vol.88 (4), p.360-376
Hauptverfasser:	Mikhael, Joseph R., MD, Dingli, David, MD, PhD, Roy, Vivek, MD, Reeder, Craig B., MD, Buadi, Francis K., MD, Hayman, Suzanne R., MD, Dispenzieri, Angela, MD, Fonseca, Rafael, MD, Sher, Taimur, MD, Kyle, Robert A., MD, Lin, Yi, MD, PhD, Russell, Stephen J., MD, PhD, Kumar, Shaji, MD, Bergsagel, P. Leif, MD, Zeldenrust, Steven R., MD, PhD, Leung, Nelson, MD, Drake, Matthew T., MD, PhD, Kapoor, Prashant, MD, Ansell, Stephen M., MD, PhD, Witzig, Thomas E., MD, Lust, John A., MD, PhD, Dalton, Robert J., MD, Gertz, Morie A., MD, Stewart, Keith, MBChB, Rajkumar, S. Vincent, MD, Chanan-Khan, Asher, MD, Lacy, Martha Q., MD
Format:	Artikel
Sprache:	eng
Schlagworte:	Antineoplastic Agents - therapeutic use Care and treatment Combined Modality Therapy Diagnosis Genetic Markers Humans Immunologic Factors - therapeutic use Induction Chemotherapy Internal Medicine Maintenance Chemotherapy Multiple myeloma Multiple Myeloma - diagnosis Multiple Myeloma - genetics Multiple Myeloma - therapy Practice guidelines (Medicine) Risk Assessment Risk factors Stem Cell Transplantation
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Zusammenfassung:	Abstract Multiple myeloma remains an incurable neoplasm of plasma cells that affects more than 20,000 people annually in the United States. There has been a veritable revolution in this disease during the past decade, with dramatic improvements in our understanding of its pathogenesis, the development of several novel agents, and a concomitant doubling in overall survival. Because multiple myeloma is a complex and wide-ranging disorder, its management must be guided by disease- and patient-related factors; emerging as one of the most influential factors is risk stratification, primarily based on cytogenetic features. A risk-adapted approach provides optimal therapy to patients, ensuring intense therapy for aggressive disease and minimizing toxic effects, providing sufficient but less intense therapy for low-risk disease. This consensus statement reflects recommendations from more than 20 Mayo Clinic myeloma physicians, providing a practical approach for newly diagnosed patients with myeloma who are not enrolled in a clinical trial.
ISSN:	0025-6196 1942-5546
DOI:	10.1016/j.mayocp.2013.01.019