Is a bone marrow biopsy necessary in a patient with a previous tissue diagnosis of plasmacytoma or smoldering multiple myeloma, who now meets criteria for active myeloma?  

Assuming there is clear laboratory and/or imaging evidence of disease progression, and assuming FISH data is already available from a prior biopsy, does a repeat marrow ever change management prior to initiation of systemic therapy?

Answer from: Medical Oncologist at Academic Institution