Leukemia 2022 Apr 11
Correction: Monoclonal proteinuria predicts progression risk in asymptomatic multiple myeloma with a free light chain ratio ≥100.
Related Questions
Do you always start treatment for patients who meet diagnostic criteria for multiple myeloma by SLiM criteria alone?
1
2 Answers
Mednet Member
Medical Oncology · Winship Cancer Institute of Emory University
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 criteria in 7...
How would you approach therapy for a patient with smoldering multiple myeloma whose light chain ratio has increased to greater than 100 over several years in the absence of any other myeloma-defining events?
2
2 AnswersMednet Member
Medical Oncology · Winship Cancer Institute of Emory University
I struggle with this as well, but the serum free light chain ratio (SFLC-R) at 100 is not magical for a patient that you've been following. An SFLC-R>100 is predictive of an increased risk to develop CRAB criteria of 60-90% w/in 2 years. This prediction is refined by measuring 24hr UPEP using a bar ...