Topics:
Hematologic Malignancies • Medical Oncology • Myeloma • NCI-CCC Tumor Board Question • University of Chicago • NCI-CCC Myeloma Tumor Board Question • Multiple Myeloma
Do you always start treatment for patients who meet diagnostic criteria for multiple myeloma by SLiM criteria alone?
i.e., 60+% bone marrow plasmacytosis, light chain ratio >100, and/or >1 MRI lesion
Answer from: Medical Oncologist at Community Practice
No, I definitely do not always start treatment for patients who meet the so-called myeloma defining events. These are guidelines, like the Pirate Code. Sixty percent plasma cells mean reaching CRAB criteria in 2 years in 95% of patients, greater than one 5 mm MRI abnormality means CRAB criteri...
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Answer from: Medical Oncologist at Academic Institution
I agree with @Craig C. Hofmeister - the expanded diagnostic criteria have no direct clinical impact and do not carry quite the same weight as the classic CRAB criteria. I have several elderly patients whose light chain ratios surpassed 100, and who after a balanced discussion opted to defer treatmen...