Would you consider starting myeloma treatment in a patient with detectable monoclonal protein, non-FDG avid lytic bone lesions, and bone marrow clonal plasma cells <10%?

The presence of lytic lesions should be considered diagnostic of myeloma and FDG uptake is not mandatory for making a diagnosis. While diagnostic criteria require 10% plasma cells, these should be interpreted in the clinical context, and in a patient with lytic lesions that are consistent with myelo...

The presence of multiple lytic lesions along with an M protein and clonal plasma cells in the bone marrow, albeit less than 10%, is what we have traditionally called macrofocal myeloma. This should be treated in line with newly diagnosed myeloma.

A couple of points to highlight:

• Bone marrow involve...