[Beacon Staff]

mSMART guidelines, relapsed myeloma (2015-03 update)

by Beacon Staff on Fri Apr 03, 2015 1:26 am

The Mayo Clinic has updated its treatment guidelines for relapsed multiple myeloma for the second time this year. They were previously updated two months ago, as discussed in this forum thread.

The new guidelines for the treatment of relapsed multiple myeloma are available at this link (PDF file with guidelines).

The guidelines classify relapsed patients into standard-risk, intermediate-risk, and high-risk categories based primarily on chromosomal abnormalities, but also on length of time in remission (or since diagnosis).

Treatment recommendations are made for patients in first relapse and in second relapse.

For first relapse, the recommended treatment depends heavily on whether or not the patient had an upfront transplant and whether or not they have been on maintenance therapy.

For second and later relapses, patients are divided into three possible categories:

1. Those who do not have plasma cell leukemia (PCL) or extramedullary disease (EMD)
2. Those with PCL or extensive EMD
3. Those who are "quadruple refractory"

Please feel free to comment in this thread on any aspects of the revised guidelines you find interesting.

[lys2012]

Re: mSMART guidelines, relapsed myeloma (2015-03 update)

by lys2012 on Sun Apr 05, 2015 10:38 pm

I have standard risk myeloma. I am currently relapsing but with a slowly rising M-spike so no treatment at the moment. I know my treatment will involve a second transplant followed by maintenance. (no maintenance the first time) Not sure what chemo for induction though. Did CyBorD when I was first diagnosed. Probably will be Rev up front since I have not had it yet. So it seems right in line with what Mayo is recommending. I am in Canada, Rev was not approved yet when I was first diagnosed in 2010, it was only available in the relapsed setting.