SWOG ONCOLOGY RESEARCH PROFESSIONAL (ORP) MANUAL RESPONSE ASSESSMENT MYELOMA CHAPTER 11C REVISED: SEPTEMBER 2016
|
|
- Michael Mills
- 6 years ago
- Views:
Transcription
1 MYELOMA Quantitative Markers-Myeloma Assessment Quantitative markers are biochemicals that are recorded in tests on body fluids such as serum and urine. Applicable Disease Sites The myeloma disease site uses markers in quantified disease assessment. The markers examined are the serum M protein, urine M protein, and serum free light chain levels. These markers are assessed regularly to see by what percentage they have increased or decreased from their value at baseline. In addition, in patients whose markers indicate that they are responding to treatment, the bone marrow is also assessed for a decrease in the plasma cells. Response Assessment Specific criteria for assessing response are found in Section 10.0 of each protocol. The two versions of the response criteria listed below are representative of the versions that are used most often. In 2006, the International Myeloma Working Group published the International Uniform Response Criteria for Multiple Myeloma, on which the first version listed is based. This version of the criteria is standard in all SWOG multiple myeloma protocols activated after January 1, The second version listed is representative of the criteria used in some SWOG multiple myeloma protocols activated prior to January 1, Since the criteria used are unique to each protocol, the protocol must be consulted prior to assessing response. Response Assessment for Studies Activated Since January 1, 2006 This version of the response criteria is based on the International Uniform Response Criteria for Multiple Myeloma, and is standard in all protocols activated after January 1, Measurability of Disease Measurable Disease: Measurable, quantifiable protein criteria must be present. Acceptable protein criteria are: Serum M protein 1 g/dl ( 10 g/l), quantified by using densitometry on serum protein electrophoresis (SPEP). AND / OR Urine M protein [Bence-Jones Protein] 200 mg/24 hrs (> 0.2 g/24 hrs), quantified by 24-hour urine protein electrophoresis (UPEP). AND/OR Bone marrow plasma cells 30% Chapter 11C - Page 1 ORP Manual Version 3.0
2 OR Patients who have both serum M protein levels < 1 g/dl AND urine M protein levels < 200 mg/24 hrs at baseline may be followed by serum free light chain (FLC) assay if involved free light chain level 10 mg/dl ( 100mg/L). Oligosecretory and Non-secretory Disease: Patients that do not meet the criteria for measurable disease above may only be assessed for the following objective statuses: Stringent Complete Response, Stable, and Progression. Criteria for Objective Status scr CR VGPR PR STA Stringent Complete Response: Meets all of the criteria for Complete Response (CR) and normal serum free light chain ratio and absence of clonal cells in bone marrow by immunohistochemistry or immunofluorescence Complete Response: Disappearance of all evidence of serum and urine M proteins on immunofixation electrophoresis studies and 5% plasma cells in bone marrow and disappearance of any soft tissue plasmacytomas Very Good Partial Response: Meets all of the criteria for Partial Response (PR) and Serum and urine M proteins detectable by immunofixation but not on electrophoresis or 90% reduction in serum M protein and urine M protein < 100 mg/24 hrs. Partial Response: If the patient had soft tissue plasmacytomas present at baseline and they were assessed at this disease assessment: 50% reduction in size of soft tissue plasmacytomas and If the patient had 30% plasma cells in bone marrow at baseline and a bone marrow biopsy was done: 50% reduction in plasma cells and 50% reduction in serum M protein and reduction in urine M protein 90% or to < 200 mg/24hr or If patient had serum M protein < 1 g/dl, urine M protein < 200 mg/24 hrs, and an involved serum free light chain level 10 mg/dl at baseline: 50% decrease in the difference between involved and uninvolved serum free light chain levels Stable Disease: Patient does not meet criteria for Stringent Complete Response, Complete Response, Very Good Partial Response, Partial Response, or Progression. Chapter 11C - Page 2 ORP Manual Version 3.0
3 PROG Progression: Any one or more of the following: Serum M protein increase 25% from baseline (or an increase of 1 g/dl if serum M protein was 5 g/dl at baseline), with an absolute increase of 0.5 g/dl or Urine M protein increase 25% from baseline, with an absolute increase of 200 mg/24 hrs or If patient had serum M protein < 1 g/dl, urine M protein < 200 mg/24 hrs, and an involved serum free light chain level 10 mg/dl at baseline: 25% increase in the difference between involved and uninvolved serum free light chain level, with an absolute increase of 10 mg/dl or Bone marrow plasma cell percentage increase 25% from baseline, with the absolute plasma cell % 10% or New bone lesions or soft tissue plasmacytomas, or definite increase in size of existing bone lesions or soft tissue plasmacytomas or Development of hypercalcemia (corrected serum calcium > 11.5 mg/dl or 2.65 mmol/l that can be attributed solely to multiple myeloma Notes M protein may also be known by the following synonyms: M-spike, monoclonal protein, myeloma protein, monoclonal paraprotein, M-component. Urine M protein measurement is estimated using 24-hour urine protein electrophoresis (UPEP) only. Random or 24-hour urine tests measuring kappa and lambda light chain levels are not reliable and are not recommended. Patients with measurable disease in both the serum and urine (serum M protein 1g/dL and urine M protein 200 mg/24h) at baseline need to be followed by both SPEP and UPEP for response assessment. Except for assessment of Complete Response, patients with measurable disease restricted to the serum (serum M protein 1 g/dl and urine M protein < 200 mg/24h) at baseline may be followed by SPEP only. Likewise, except for assessment of Complete Response, patients with measurable disease restricted to the urine (serum M protein < 1 g/dl and urine M protein 200 mg/24h) at baseline may be followed by UPEP only. Patients with serum M protein 1 g/dl and/or urine M protein 200 mg/24h at baseline will be assessed for response based on SPEP and/or UPEP results only. Except for assessment of Stringent Complete Response, serum free light chain (FLC) assay response requirements are only applicable to patients who had serum M protein < 1 g/dl, urine M protein < 200 mg/24 hrs, and an involved serum free light chain level 10 mg/dl at baseline. A normal serum free light chain ratio is required for all patients for a Stringent Complete Response. To qualify for a Complete Response, both serum and urine immunofixation must be carried out and must be negative, regardless of the size of the baseline M protein in the serum or urine. Skeletal survey is not required for assessment of response unless clinically indicated, but is recommended once a year in clinical practice. Stringent Complete Response, Complete Chapter 11C - Page 3 ORP Manual Version 3.0
4 Response, Very Good Partial Response, Partial Response, and Stable Disease all require no known evidence of progressive or new bone lesions if radiographic studies were performed, but radiographic studies are not required to satisfy these response requirements. The size of the soft tissue plasmacytomas is defined as the sum of the products of the crossdiameters of each plasmacytoma. The size of the bone lesions will be determined in a similar manner. A definite increase in the size is defined as a 50% increase (and at least 1 cm 2 ) of this sum. Criteria for Best Response This is calculated from a sequence of objective status evaluations. scr CR VGPR PR UsCR UCR UVGPR Stringent Complete Response: An objective status of Stringent Complete Response on at least two sequential disease assessments. Only one bone marrow biopsy, done during one of these two disease assessments, is required to confirm the response. Complete Response: An objective status of Complete Response on at least two sequential disease assessments. Only one bone marrow biopsy, done during one of these two disease assessments, is required to confirm the response. Very Good Partial Response: An objective status of Very Good Partial Response on at least two sequential disease assessments. Partial Response: An objective status of Partial Response on at least two sequential disease assessments. Unconfirmed scr: One objective status of Stringent Complete Response (based on evidence from serum and urine studies and, if drawn, bone marrow biopsy) but the confirmation studies are either not done, or when done, do not meet the requirements necessary to confirm response. This must be documented before progression and at least three weeks after registration. Unconfirmed CR: One objective status of Complete Response (based on evidence from serum and urine studies and, if drawn, bone marrow biopsy) but the confirmation studies are either not done, or when done, do not meet the requirements necessary to confirm response. This must be documented before progression and at least three weeks after registration. Unconfirmed VGPR: One objective status of Very Good Partial Response, but the confirmation studies are either not done, or when done, do not meet the requirements necessary to confirm response. This must be documented before progression and at least three weeks after registration. Chapter 11C - Page 4 ORP Manual Version 3.0
5 UPR STA INC NASS Unconfirmed PR: One objective status of Partial Response, but the confirmation studies are either not done, or when done, do not meet the requirements necessary to confirm response. This must be documented before progression and at least three weeks after registration. Stable / No Response: At least one objective status of Stable at least three weeks after registration, but not qualifying as any of the above. If radiographic studies were performed there should be no known progressive or new bone lesions. Increasing Disease: First objective status recorded (other than Unknowns or those before three weeks) of Progression, provided this occurs within eight weeks of registration. Inadequate Assessment, Response Unknown: Progression greater than eight weeks after registration and either all objective statuses prior to registration are unknown or the only known objective statuses occurred less than three weeks after registration. Response Assessment for Studies Activated Prior to January 1, 2006 This version of the response criteria is representative of the criteria used in some SWOG multiple myeloma protocols activated prior to January 1, Please note that prior to January 1, 2006 SWOG did not have a standard multiple myeloma response criteria, so you MUST consult section 10.0 of the treatment protocol prior to assessing patient response. Measurability of Disease Measurable Disease: Measurable, quantifiable protein criteria must be present. Acceptable protein criteria are quantifiable ( 1.0 g/dl [10.0 g/l] serum M-protein of IgG, IgA, IgD, IgE isotype and/or urine M-protein [Bence-Jones Protein] ( 200 mg/24 [ 0.2 g/24 hrs]). Patients with IgM peaks must have either 20% bone marrow plasmacytosis or > 3 lytic lesions on the skeletal survey. Chapter 11C - Page 5 ORP Manual Version 3.0
6 Criteria for Objective Status CR Complete Remission: Absence of bone marrow or blood findings of multiple myeloma. This includes disappearance of all evidence of serum and urine M-proteins on immunofixation electrophoresis studies. Normalization of serum concentrations of normal immunoglobulins is not required for CR. There must also be no evidence of increasing anemia. Bone marrow cellularity must be 20% with plasma cells 5%. REM Remission: A 75% reduction in the serum M-protein, and if a urine M- protein (Bence-Jones protein) is present, either a 90% reduction in this protein, or a urine M-protein < 0.2 g/day. Bone marrow plasma cells must be 5%. PR STA PROG REL Partial Remission: A 50% reduction in the serum M-protein, and if present, a 50% reduction in the urine M-protein (Bence-Jones protein). Bone marrow plasma cells must not be increased from baseline level. Stable / No Remission: A < 50% reduction in the serum M-protein, or if the patient has light-chain disease only, a < 50% reduction in the urine M-protein (Bence-Jones protein). Patients not qualifying for remission or progression. Progression: In patients with no confirmed Partial Remission, Remission, or Complete Remission, Progression is defined as a > 25% increase from baseline in myeloma protein production or other signs of disease progression such as hypercalcemia, etc. Relapse: In patients with a confirmed Partial Remission, Remission, or Complete Remission (The patient must have had an objective status of Partial Remission, Remission, or Complete Remission on two successive disease assessments performed at least six weeks apart - with or without a bone marrow biopsy.), Relapse is defined as the first occurrence of any of the following: 1) a myeloma protein increase by100% from the lowest level recorded on study, provided the absolute magnitude of this increase is at least 1 g/dl for a serum monoclonal protein or at least 500 mg/24 hrs of urine M-protein; 2) a myeloma protein increase above the response criteria for PR (see criteria for Partial Remission), with the same requirements for the absolute magnitude of the protein increase; 3) reappearance of any myeloma peak that had disappeared while on protocol treatment, provided it meets the same requirements listed above; 4) increase in the size and number of lytic bone lesions recognized on radiographs. Chapter 11C - Page 6 ORP Manual Version 3.0
7 Notes In all remissions, the serum calcium must remain normal, and where a skeletal survey is required, the size and number of lytic lesions must not increase. Criteria for Best Response This is calculated from a sequence of objective status evaluations. CR REM PR UCR UREM UPR STA Complete Remission: An objective status of Complete Remission on at least two disease assessments performed at a minimum of six weeks apart. A bone marrow biopsy and a skeletal survey must be done during one of these two disease assessments. The skeletal survey must either show recalcification or no change in osteolytic lesions. Remission: An objective status of Remission on at least two disease assessments performed at a minimum of six weeks apart. A bone marrow biopsy must be done during one of these two disease assessments. If the patient has new symptoms of pain, a skeletal survey must also be done. Partial Remission: An objective status of Partial Remission on at least two disease assessments performed at a minimum of six weeks apart. A bone marrow biopsy must be done during one of these two disease assessments. If the patient has new symptoms of pain, a skeletal survey must also be done. Unconfirmed CR: One objective status of Complete Remission based on evidence from serum and urine protein, with or without a bone marrow biopsy, documented before progression and at least three weeks after registration, but the confirmation studies are either not done, or when done, do not meet the requirements necessary to confirm response. Unconfirmed REM: One objective status of Remission based on evidence from serum and urine protein, with or without a bone marrow biopsy, documented before progression and at least three weeks after registration, but the confirmation studies are either not done, or when done, do not meet the requirements necessary to confirm response. Unconfirmed PR: One objective status of Partial Remission based on evidence from serum and urine protein, with or without a bone marrow biopsy, documented before progression and at least three weeks after registration, but the confirmation studies are either not done, or when done, do not meet the requirements necessary to confirm response. Stable / No Remission: At least one objective status of Stable at least three weeks after registration, but not qualifying as any of the above. Chapter 11C - Page 7 ORP Manual Version 3.0
8 INC NASS Increasing Disease: First objective status recorded (other than Unknowns or those before three weeks) of Progression, provided this occurs within eight weeks of registration. Inadequate Assessment, Response Unknown: Progression greater than eight weeks after registration and either all objective statuses prior to registration are unknown or the only known objective statuses occurred less than three weeks after registration. Baseline and Follow-up Studies In order to assess the patient s response to treatment, it is crucial that we get an accurate depiction of the patient s disease status at baseline. And since each patient s disease markers may display in a different manner in the serum, urine, and bone marrow, all patients must have all of these sites assessed at baseline. Once on study, however, the follow-up tests required to assess the patient s response to treatment may differ from patient to patient, depending on what their disease status was at baseline. The disease marker that is examined in the urine is the urine M protein, which is also sometimes called Bence-Jones protein. This protein is assessed by using two different tests: urine electrophoresis (UPEP) and urine immunofixation electrophoresis (UIFE). The UIFE checks for the presence of the M protein and identifies what type of protein it is, and the UPEP measures the amount of M protein that is present. For SWOG studies, both of these tests must be performed on 24 hour urine samples, and the M protein must be quantified (given a numerical value) on the UPEP. Urine M protein measurements obtained from UPEPs done on random urine samples, or quantified from urine tests that only measure urine kappa and lambda lights chain levels, are not considered reliable and the values obtained from these tests will not be accepted by SWOG. At baseline, these tests must be done within 28 days prior to registration. In the serum, the disease marker that is examined is the serum M protein. Like in the urine, this protein is assessed by two tests: serum protein electrophoresis (SPEP) and serum immunofixation electrophoresis (SIFE). The SIFE checks for the presence and identity of the serum M protein, and the SPEP quantifies the amount of serum M protein present. For SWOG studies, the serum M protein must be quantified on the SPEP. At baseline, these tests must be done within 28 days prior to registration. In both the serum and urine, the immunofixation tests (SIFE and UIFE) are more sensitive to the presence of M protein than the protein electrophoresis tests (SPEP and UPEP). So sometimes the results from the SPEP or UPEP will indicate that there is no M protein, or that if an M protein is present it is too little to be quantified, but the SIFE or UIFE done on the same sample will indicate that an M protein is present. This is why the response criteria above specify that for a patient to be in a complete response or complete remission, both the protein electrophoresis and the immunofixation tests must be done on the serum and urine, and all tests must be negative for the presence of M protein. Chapter 11C - Page 8 ORP Manual Version 3.0
9 Additionally, the response criteria based on the International Uniform Response Criteria for Multiple Myeloma now allows for patient response to be assessed by following a patient s serum free light chain levels. These are measured by a serum free light chain assay, which is also known as a Freelite test. As explained in the criteria above, if at baseline the patient s serum M protein is < 1 g/dl and urine M protein is < 200 mg/24 hr, the patient may still be considered to have measurable disease if their involved free light chain level is 10 mg/dl. The patient will then be assessed for response based on the results from follow-up serum free light assays. For these patients, at baseline this test must be done within 28 days prior to registration. Patients who are considered to have measurable disease based on their serum and/or urine M protein levels will only need to have a free light chain assay performed when it appears that the patient has entered a stringent complete response. Bone marrow biopsies are done to assess how much of the bone marrow is comprised of plasma cells and one must be performed within 28 days prior to registration. Additional followup bone marrow biopsies may be required during the study to confirm a patient s response. Multiple Myeloma Response Exercises The following are exercises in determining patient response to treatment. Please note that the first two exercises are based on the response criteria for studies activated since January 1, The last two exercises are based on the criteria for studies activated prior to January 1, These exercises distinguish between objective status and best response. Objective status refers to the patient s response at each scheduled assessment. Best response is determined from a sequence of objective status evaluations and refers to the patient s most favorable response over all assessments up to that time point. In multiple myeloma response assessment you will often have to calculate the percent change in a value from baseline. To calculate this percent change, please use the following formula: (current value baseline value) X 100 baseline value Chapter 11C - Page 9 ORP Manual Version 3.0
10 Exercises for Studies Activated Since January 1, 2006 Exercise 1 Parameter Prestudy Week 6 Week 12 Week 18 Serum M protein 1.2 g/dl 0.5 g/dl 0.1 g/dl 0 g/dl % change from baseline -58.3% -91.7% -100% Serum IFE present present present present Urine M protein 350 mg/24h 190 mg/24h 80 mg/24h 70 mg/24h % change from baseline -45.7% -77.1% -80% Urine IFE present present present present Serum calcium 9.5 mg/dl 9.8 mg/dl 9.9 mg/dl 9.6 mg/dl BM plasma cell % 20% Plasmacytomas none Objective Status PR VGPR VGPR Best Response at Time Point UPR UVGPR VGPR Best Response Overall VGPR Note that at week 6, while the urine M protein had only decreased 45.7% from baseline, the absolute value of the urine M protein was < 200 mg/24h, and thus the patient still met the criteria for an objective status of Partial Response (PR). Exercise 2 Parameter Prestudy Week 6 Week 12 Week 18 Serum M protein 0.3 g/dl 0.1 g/dl 0 g/dl Serum IFE present present present Urine M protein 0 mg/24h 0 mg/24h Urine IFE absent absent Serum FLC involved lambda lambda lambda Serum FLC kappa 0.01 mg/dl 0.15 mg/dl 0.22 mg/dl Serum FLC lambda 298 mg/dl 103 mg/dl 1.28 mg/dl Serum FLC (involved mg/dl uninvolved) mg/dl mg/dl % change in (involved -65.5% -99.6% uninvolved) from baseline Serum calcium 10.4 mg/dl 10.1 mg/dl 9.8 mg/dl BM plasma cell % 35% 5% % change in BM plasma cell % -85.7% from baseline Plasmacytomas none none Objective Status PR VGPR Best Response at Time Point UPR UVGPR Best Response Overall UVGPR Chapter 11C - Page 10 ORP Manual Version 3.0
11 At baseline this patient s serum M protein was < 1 g/dl, and the urine M protein was < 200 mg/24h. However, the serum free light chain assay showed an involved free light chain, in this case lambda, that was 10 mg/dl. So this patient is considered to have measurable disease, and is followed by serum free light chain assay. Please note that an objective status could not be determined for the week 12 assessment. Since this patient is being followed by serum free light chain assay, if this test is not done we cannot determine how the patient is responding to treatment. You should always make sure to do all tests that section 10 requires for your patient (SPEP and/or UPEP or serum free light chain assay) at every disease assessment. The week 18 assessment was very close to qualifying as a Complete Response (CR), but the serum immunofixation electrophoresis test showed that the serum M protein was still present. Thus, the objective status for this assessment was a Very Good Partial Response (VGPR). Exercises for Studies Activated Prior to January 1, 2006 Exercise 3 Parameter Prestudy Week 6 Week 12 Week 18 Serum M protein 8.2 g/dl 1.2 g/dl 0 g/dl 0 g/dl % change from baseline -85.4% -100% -100% Serum IFE present present absent absent Urine M protein 180 mg/24h 50 mg/24h 0 mg/24h 0 mg/24h Urine IFE present present absent absent BM plasma cell % 18% 3% BM cellularity % 70% 50% Bone lesions 1 none Increasing anemia? yes yes no no Objective Status REM CR CR Best Response at Time Point UREM UCR CR Best Response Overall CR The week 18 assessment confirmed that the patient was experiencing a Complete Remission (CR). Please note that for the week 18 best response to be categorized as a CR a bone marrow biopsy and a skeletal survey had to be done in addition to the serum and urine studies. Chapter 11C - Page 11 ORP Manual Version 3.0
12 Exercise 4 Parameter Prestudy Week 6 Week 12 Week 18 Serum M protein 0 g/dl 0 g/dl 0 g/dl 0 g/dl Serum IFE absent absent present present Urine M protein 480 mg/24h 216 mg/24h 365 mg/24h 615 mg/24h % change from baseline -55% -24% +28.1% Urine IFE present present present present BM plasma cell % 22% BM cellularity % 80% Bone lesions multiple Objective Status PR STA PROG Best Response at Time Point UPR UPR UPR Best Response Overall UPR At week 18 this patient s urine M protein level increased by 28.1%, which qualified this patient for an objective status of progression. Please note that in many protocols the study calendar may request that other extra tests, like a bone marrow biopsy, be done when the patient has progressed. Chapter 11C - Page 12 ORP Manual Version 3.0
Tracking Disease Status for Multiple Myeloma
Tracking Disease Status for Multiple Myeloma This appendix is intended to provide additional resources when determining: Best response to line of therapy pre-transplant; Disease Status at the Last Evaluation
More informationMYE FORMS REVEALED RESPONSE CODES OBJECTIVES. Stringent Complete Response (scr) Complete Response (CR) I have no conflicts of interest to disclose
I have no conflicts of interest to disclose MYE FORMS REVEALED Janet Brunner, PA-C CIBMTR MKE New10_1.ppt OBJECTIVES 1) Be able to describe the criteria required for each myeloma response code 2) Be able
More informationCriteria for Disease Assessment Joan Bladé
Criteria for Disease Assessment Joan Bladé Unidad de Amiloidosis y Mieloma Servicio de Hematología Hospital Clínic de Barcelona COMy Meeting, París, May 4th, 2018 Response Evaluation EBMT, 1998 - CR and
More informationInstructions for Plasma Cell Disorders (PCD) Post-HCT Data (Form 2116 Revision 3)
(Form 2116 Revision 3) This section of the CIBMTR Forms Instruction Manual is intended to be a resource for completing the Plasma Cell Disorders (PCD) Post-HCT Data Form. E-mail comments regarding the
More information2016: Plasma Cell Disorders Pre-HCT Data
2016: Plasma Cell Disorders Pre-HCT Data Registry Use Only Sequence Number: Date Received: Key Fields CIBMTR Center Number: Date of HCT for which this form is being completed: / / YYYY MM DD HCT type (check
More informationPlasma Cell Disorders (PCD) Pre-HCT Data
Plasma Cell Disorders (PCD) Pre-HCT Data Registry Use Only Sequence Number: Date Received: CIBMTR Center Number: CIBMTR Recipient ID: Date of HCT for which this form is being completed: HCT type: (check
More informationIf unqualified, Complete remission is considered to be Haematological complete remission
Scroll right to see the database codes for Disease status and Response Diagnosis it refers to Disease status or response to treatment AML ALL CML CLL MDS or MD/MPN or acute leukaemia secondary to previous
More informationIf unqualified, Complete remission is considered to be Haematological complete remission
Scroll right to see the database codes for Disease status and Response Diagnosis it refers to Disease status or response to treatment AML ALL CML CLL MDS or MD/MPN or acute leukaemia secondary to previous
More informationImportancia del laboratorio en el seguimiento clínico de pacientes con mieloma múltiple
Importancia del laboratorio en el seguimiento clínico de pacientes con mieloma múltiple Joan Bladé Unidad de Amiloidosis y Mieloma Servicio de Hematología Hospital Clínic de Barcelona Málaga, 16 de noviembre
More informationForms Revision: Myeloma Changes
Sharing knowledge. Sharing hope. Forms Revision: Myeloma Changes J. Brunner, PA-C and A. Dispenzieri, MD February 2013 Disclosures Janet Brunner, PA-C I have no relevant conflicts of interest to disclose.
More informationSupplementary Appendix
Supplementary Appendix This appendix has been provided by the authors to give readers additional information about their work. Supplement to: Lonial S, Dimopoulos M, Palumbo A, et al. Elotuzumab therapy
More informationSmoldering Multiple Myeloma. A Case Study
Smoldering Multiple Myeloma A Case Study Case Presentation 53-Year-Old Male Patient presented for a routine exam No prior history of disease or family history of fhematologic disorders d or malignancies,
More informationMultiple myeloma Biological & Clinical Aspects Isabelle Vande Broek, MD, PhD
Multiple myeloma Biological & Clinical Aspects Isabelle Vande Broek, MD, PhD Department of Oncology & Hematology AZ Nikolaas Iridium Kanker Netwerk Introduction Multiple myeloma = Kahler s disease Dr.
More informationMultiple Myeloma 101: Understanding Your Labs
Multiple Myeloma 101: Understanding Your Labs Tim Wassenaar MD MS Hematologist, Director of Clinical Trials UW Cancer Center at ProHealth Care None Disclosures Outline Define hematopoiesis WBCs, RBCs,
More informationSerum Free Light Chains should be the target of response evaluation in light chain myeloma rather than urines: results from the IFM 2009 trial
Serum Free Light Chains should be the target of response evaluation in light chain myeloma rather than urines: results from the IFM 2009 trial Jill Corre*, Thomas Dejoie, Helene Caillon, Michel Attal*,
More informationFAQs- Janet s Inbox. Janet Brunner, PA-C Wed. Feb. 26, 2014 TRAINING & DEVELOPMENT 1.
FAQs- Janet s Inbox Janet Brunner, PA-C Wed. Feb. 26, 2014 TRAINING & DEVELOPMENT 1. Disclosures I have no relevant conflicts of interest to disclose. TRAINING & DEVELOPMENT 2. Objectives 1. Determine
More informationManagement of Multiple Myeloma
Management of Multiple Myeloma Damian J. Green, MD Fred Hutchinson Cancer Research Center/ Seattle Cancer Care Alliance New Treatment Options Have Improved OS in MM Kumar SK, et al. Blood. 2008;111:2516-2520.
More informationHevylite assays de - convoluted. Dr Karthik Ramasamy Oxford University Hospitals
Hevylite assays de - convoluted Dr Karthik Ramasamy Oxford University Hospitals Overview Hevylite assay Introduction Clinical utility of Hevylite 2 Hevylite specifici.es Hevylite specifici.es Hevylite
More informationReview of the recent publications from the French group of myeloma on urine vs serum FLC analysis in MM
Review of the recent publications from the French group of myeloma on urine vs serum FLC analysis in MM Multiple myeloma Response evaluation Kumar Lancet Oncol 2016; 17: e328 46 Cumulative Proportion Surviving
More informationHematology 101. Rachid Baz, M.D. 5/16/2014
Hematology 101 Rachid Baz, M.D. 5/16/2014 Florida 101 Epidemiology Estimated prevalence 8,000 individuals in U.S (compare with 80,000 MM patients) Annual age adjusted incidence 3-8/million-year 1 More
More informationThe Paraprotein. Evaluating Paraproteinemia. Conditions Associated with PP. Paraprotein Structure
Evaluating Paraproteinemia Jeffrey Wolf, MD, Director Thomas Martin, MD, Associate Director Myeloma Institute University of California, San Francisco The Paraprotein An abnormal immunoglobulin or part
More informationM-Protien, what to do next? Ismail A Sharif MD, FRCPc Internal Medicine Day 22 nd April 2016
+ M-Protien, what to do next? Ismail A Sharif MD, FRCPc Internal Medicine Day 22 nd April 2016 + Disclosures Advisory Boards: AMGEN, Lundbeck, NOVARTIS + Subtypes of Plasma Cell Disorders Increased Plasma
More informationEvaluating Paraproteinemia
Evaluating Paraproteinemia Jeffrey Wolf, MD, Director Thomas Martin, MD, Associate Director Myeloma Institute University of California, San Francisco The Paraprotein An abnormal immunoglobulin or part
More informationSWOG ONCOLOGY RESEARCH PROFESSIONAL (ORP) MANUAL RESPONSE ASSESSMENT LYMPHOMA CHAPTER 11B REVISED: SEPTEMBER 2016
LYMPHOMA Definitions of Response According to Non Hodgkin s Lymphoma (NHL) Criteria Listed below is the new NCI Lymphoma criteria for evaluation and endpoint definitions for Non Hodgkin s Lymphoma response
More informationLaboratory Examination
Todd Zimmerman, M.D. 64 year old African American male presents to establish care with PCG. Meds: Norvasc 5 mg daily PMHx: HTN x 20 years, poorly controlled SHx: No tobacco, illicit; rare EtOH ROS: Negative
More informationSerum free light chain (SFLC) assays. Dr Sarah Sasson SydPath Registrar
Serum free light chain (SFLC) assays Dr Sarah Sasson SydPath Registrar Introduction to SFLC Plasma cell dyscrasias such as monoclonal gammopathy of uncertain significance (MGUS) smouldering/asymptomatic
More informationIs Transplant a Necessity or a Choice: Focus on the necessity for CR and MRD
Is Transplant a Necessity or a Choice: Focus on the necessity for CR and MRD Ajai Chari, MD Associate Professor of Medicine Director of Clinical Research Multiple Myeloma Program Mount Sinai Medical Center
More informationMultiple myeloma. November 24, 2017 at Vientiane, Laos
Multiple myeloma November 24, 2017 at Vientiane, Laos Teeraya Puavilai, M.D. Division of Hematology, Department of Medicine Faculty of Medicine Ramathibodi, Mahidol University, Thailand Multiple myeloma
More informationEXPERIMENTAL AND THERAPEUTIC MEDICINE 9: , 2015
EXPERIMENTAL AND THERAPEUTIC MEDICINE 9: 1895-1900, 2015 Clinical characteristics of a group of patients with multiple myeloma who had two different λ light chains by immunofixation electrophoresis: A
More informationSuspecting Tumors, or Could it be cancer?
Suspecting Tumors, or Could it be cancer? Donna E. Reece, M.D. Princess Margaret Cancer Centre University Health Network Toronto, ON CANADA 07 February 2018 Background Low back pain is common However,
More informationMultiple Myeloma (MM)
EloreMed Editor: Le Wang, MD, PhD Date of Update: 2/14/2018 UpToDate: New FDA approval anti-myeloma drugs: Carfizomid, Ixazomib, Daratumumab, Elotumumab, Pomalidomide. Autologous stem cell transplantation
More informationCase #1. Robert J. Glinert, M.D. David C. Fisher, M.D. Dana Farber Cancer Institute
Case #1 Robert J. Glinert, M.D. David C. Fisher, M.D. Dana Farber Cancer Institute Patient History Part I 76 year-old man 1997 diagnosed with MGUS (biclonal) during evaluation of (self-limited) anemia.
More informationSouthern Derbyshire Shared Care Pathology Guidelines. MGUS (Monoclonal Gammopathy of Undetermined Significance)
Southern Derbyshire Shared Care Pathology Guidelines MGUS (Monoclonal Gammopathy of Undetermined Significance) Purpose of guideline This guideline provides information about the risk stratification of
More informationCurrent management of multiple myeloma. Jorge J. Castillo, MD Assistant Professor of Medicine Harvard Medical School
Current management of multiple myeloma Jorge J. Castillo, MD Assistant Professor of Medicine Harvard Medical School JorgeJ_Castillo@dfci.harvard.edu Multiple myeloma MM is a plasma cell neoplasm characterized
More informationMultiple Myeloma Early Detection, Diagnosis, and Staging
Multiple Myeloma Early Detection, Diagnosis, and Staging Detection and Diagnosis Catching cancer early often allows for more treatment options. Some early cancers may have signs and symptoms that can be
More informationPLASMA CELL NEOPLASIA. Michael Miller, MD & Ajaz Shawl, MD
PLASMA CELL NEOPLASIA Michael Miller, MD & Ajaz Shawl, MD Plasma Cell Neoplasia Board Questions Case Presentation Introduction Epidemiology Presentation Diagnosis Laboratory Tests Imaging Differentials
More informationNCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ) Multiple Myeloma. Version NCCN.org
NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ) Version 1.2011 NCCN.org The NCCN Guidelines are a statement of evidence and consensus of the authors regarding their views of currently
More informationCase Study Discussions on the Nurse s Role in Caring for Patients With Hematologic Malignancies
Case Study Discussions on the Nurse s Role in Caring for Patients With Hematologic Malignancies Case Study Discussions on the Nurse s Role in Caring for Patients With Hematologic Malignancies Welcome and
More informationJo Abraham MD Division of Nephrology University of Utah
Jo Abraham MD Division of Nephrology University of Utah 68 year old male presented 3 weeks ago with a 3 month history of increasing fatigue He reported a 1 week history of increasing dyspnea with a productive
More informationCitation for published version (APA): Hovenga, S. (2007). Clinical and biological aspects of Multiple Myeloma s.n.
University of Groningen Clinical and biological aspects of Multiple Myeloma Hovenga, Sjoerd IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from
More informationSmoldering Myeloma: Leave them alone!
Smoldering Myeloma: Leave them alone! David H. Vesole, MD, PhD Co-Director, Myeloma Division Director, Myeloma Research John Theurer Cancer Center Hackensack University Medical Center Prevalence 1960 2002
More informationWHO Classification. B-cell chronic lymphocytic leukemia/small T-cell granular lymphocytic leukemia
Blood Malignancies-II Prof. Dr. Herman Hariman, a Ph.D, SpPK (KH). Prof. Dr. Adikoesoema Aman, SpPK (KH) Dept. of Clinical Pathology, School of Medicine, University of North Sumatra WHO classification
More informationSerum Free Light Chain Assay
Serum Free Light Chain Assay This Infosheet explains what light chains are, what the Serum Free Light Chain Assay is, and why it is used in AL amyloidosis. In AL amyloidosis, abnormal plasma cells in the
More informationNIH Public Access Author Manuscript Leukemia. Author manuscript; available in PMC 2009 July 1.
NIH Public Access Author Manuscript Published in final edited form as: Leukemia. 2009 January ; 23(1): 3 9. doi:10.1038/leu.2008.291. Criteria for diagnosis, staging, risk stratification and response assessment
More informationHevylite : a New Serum Test for Assessing Patients with Multiple Myeloma
Hevyite : a New Serum Test for Assessing Patients with Mutipe Myeoma Judith A. Finay, Ph.D. Director of Scientific Affairs The Binding Site, Inc. San Diego, CA 800-633-4484 X335 Some of the subject matter
More informationSerum free light chain ratio is an independent risk factor for progression in monoclonal gammopathy of undetermined significance
CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Serum free light chain ratio is an independent risk factor for progression in monoclonal gammopathy of undetermined significance S. Vincent
More informationCancer Research Group Version Date: June 22, 2016 NCI Update Date: November 13, Schema
ev. 5/14 Cancer esearch Group Schema NDUCTON 1, 3 rm Step 0 P E - E G S T T O Step 1 N D O M Z T O Stratification: ntent to stem cell transplant at progression: Yes or No Bortezomib 1.3 mg/m2 SQ or V days
More informationTarek ElBaz, MD. Prof. Internal Medicine Chief, Division of Renal Medicine Al Azhar University President, ESNT
The Kidney in Multiple Myeloma Tarek ElBaz, MD. Prof. Internal Medicine Chief, Division of Renal Medicine Al Azhar University President, ESNT Normal Cell Plasma cells produce antibodies that bind to antigens,
More informationSuccessful Treatment of Immunoglobulin D Myeloma by Bortezomib and Dexamethasone Therapy
CASE REPORT Successful Treatment of Immunoglobulin D Myeloma by Bortezomib and Dexamethasone Therapy Naohiro Sekiguchi 1, Naoki Takezako 1, Akihisa Nagata 1, Miyuki Wagatsuma 2, Satoshi Noto 1, Kazuaki
More informationV. Smoldering multiple myeloma
Hematological Oncology Hematol Oncol 2015; 33: 33 37 Published online in Wiley Online Library (wileyonlinelibrary.com).2213 Supplement Article V. Smoldering multiple myeloma María-Victoria Mateos 1 * and
More informationAnaemias and other Pesky Haematology Questions
Anaemias and other Pesky Haematology Questions 3 main topics How do I work out an anaemia.. That oh too common paraprotein patient. Those mildly raised lymphocyte count GP discussed patient with me over
More informationTESTS AND INVESTIGATIONS FOR MULTIPLE MYELOMA A guide for patients and caregivers
TESTS AND INVESTIGATIONS FOR MULTIPLE MYELOMA A guide for patients and caregivers Developed by the Myeloma Special Practice Network (M-SPN) of the Haematology Society of Australia and New Zealand (HSANZ)
More informationTreatment of Relapsed. A Case Study
Treatment of Relapsed Multiple Myeloma A Case Study Case Presentation Mr. V is a 61-year-old man previously diagnosed with ISS stage III IgG λ multiple myeloma with bone lesions, normal FISH and cytogenetics,
More informationMyeloma: Are We on the Brink of a Cure? Jeffrey Wolf, MD Director, Myeloma Program University of California, San Francisco
Myeloma: Are We on the Brink of a Cure? Jeffrey Wolf, MD Director, Myeloma Program University of California, San Francisco Survival in Myeloma IFM DFCI; 2015 2011-14 2001-10 1961-70 1991-2000 Kumar S.
More informationMajor Diagnostic Criteria
Multiple Myeloma Elizabeth Ann Coleman, PhD, RNP, AOCN Professor and Chair, Dept. of Nursing Science Cooper Chair in Oncology Nursing, College of Nursing Professor, Dept. of Internal Medicine, College
More informationLec-14 د.خالد نافع. Medicine. Multiple Myeloma
Fifth stage Lec-14 د.خالد نافع Medicine 24/4/2016 Multiple Myeloma Plasma cell myeloma Variants Non - secretory myeloma Indolent myeloma Smouldering myeloma Plasma cell leukaemia Plasmacytoma - Solitary
More informationReviewed by Dr. Michelle Geddes (Staff Hematologist, University of Calgary) and Dr. Matt Cheung (Staff Hematologist, University of Toronto)
MULTIPLE MYELOMA Updated March 2017 by Doreen Ezeife, PGY-5 resident, University of Calgary Reviewed by Dr. Michelle Geddes (Staff Hematologist, University of Calgary) and Dr. Matt Cheung (Staff Hematologist,
More informationShould we treat Smoldering MM patients? María-Victoria Mateos University Hospital of Salamanca Salamanca. Spain
Should we treat Smoldering MM patients? María-Victoria Mateos University Hospital of Salamanca Salamanca. Spain Should we treat some patients with Stage I MM? Len-dex is a promising and atractive option
More informationI nuovi fa*ori di classificazione e di rischio del Mieloma smouldering.
Dipartimento di Scienze Biomediche e Oncologia Umana Unità per lo Studio e la Terapia delle Gammopatie Monoclonali I nuovi fa*ori di classificazione e di rischio del Mieloma smouldering. Roberto Ria, M.D.
More informationManagement of Multiple Myeloma: The Changing Paradigm
Management of Multiple Myeloma: The Changing Paradigm High-Dose Chemotherapy and Stem Cell Transplantation Todd Zimmerman, MD University of Chicago Medical Center Case Presentation R.M. is a 64 year old
More informationMULTIDISCIPLINARY MULTIPLE MYELOMA CARE
MULTIDISCIPLINARY MULTIPLE MYELOMA CARE Regional Lecture Series Leveraging a Multidisciplinary Approach to Multiple Myeloma Care Leveraging a Multidisciplinary Approach to Multiple Myeloma Care Abhinav
More informationMultiple Myeloma: diagnosis and prognostic factors. N Meuleman May 2015
Multiple Myeloma: diagnosis and prognostic factors N Meuleman May 2015 Diagnosis Diagnostic assessment of myeloma: what should we know? Is it really a myeloma? Is there a need for treatment? What is the
More informationManagement of Multiple Myeloma: The Changing Paradigm
Management of Multiple Myeloma: The Changing Paradigm Frontline Therapy for Newly Diagnosed Patients Saad Usmani, MD FACP Levine Cancer Institute Introduction: Case Presentation 64-year-old woman with
More informationModule 3: Multiple Myeloma Induction and Transplant Strategies Treatment Planning
Module 3: Multiple Myeloma Induction and Transplant Strategies Treatment Planning Challenge Question: Role of Autologous Stem Cell Transplant Which of the following is true about eligibility for high-dose
More informationHematology Case Conference 8/5/03
Hematology Case Conference 8/5/03 Bone Marrow Case Patient: Emmxxx Lylexxx 74 year old AA female S/P craniotomy for SDH. Pt has Hx of HTN, DM, Crohn s disease, (R) nephrectomy. Bone marrow for abnormal
More informationCenter for Amyloidosis and Acute Phase Proteins, University College London Medical School, UK
Use of plasma cell immunophenotype as prognostic markers in patients with systemic AL amyloidosis Sajitha Sachchithanantham 1*, Anna Baginska 1*, Dorota Rowczenio 1, Shameem A Mahmood 1, Rabya Sayed 1,
More informationUnderstanding the Serum Free Light Chain Assays. Anne L Sherwood, PhD Director of Scientific Affairs The Binding Site, Inc.
Understanding the Serum Free Light Chain Assays Anne L Sherwood, PhD Director of Scientific Affairs The Binding Site, Inc. AL Amyloidosis: abnormality of proteins from Plasma Cells in the Bone Marrow Red
More informationMultiple myeloma evolves from a clinically silent premalignant
S. VINCENT RAJKUMAR Updated Diagnostic Criteria and Staging System for Multiple Myeloma S. Vincent Rajkumar, MD OVERVIEW There has been remarkable progress made in the diagnosis and treatment of multiple
More informationA.M.W. van Marion. H.M. Lokhorst. N.W.C.J. van de Donk. J.G. van den Tweel. Histopathology 2002, 41 (suppl 2):77-92 (modified)
chapter 4 The significance of monoclonal plasma cells in the bone marrow biopsies of patients with multiple myeloma following allogeneic or autologous stem cell transplantation A.M.W. van Marion H.M. Lokhorst
More informationSheena Surindran Grand Rounds 2/15/11
Sheena Surindran Grand Rounds 2/15/11 Affects 5 12 person per million / year 5 10% associated with myeloma Median survival without treatment is 12 40 months Most commonly affected organs are kidney, heart
More informationManagement Update: Multiple Myeloma. Presented by Prof. Dr. Khan Abul Kalam Azad Professor of Medicine Dhaka Medical College
Management Update: Multiple Myeloma Presented by Prof. Dr. Khan Abul Kalam Azad Professor of Medicine Dhaka Medical College Introduction Multiple myeloma - clonal plasma cell neoplasm Monoclonal antibody
More informationPlasma cell myeloma (multiple myeloma)
Plasma cell myeloma (multiple myeloma) Common lymphoid neoplasm, present at old age (70 years average) Remember: plasma cells are terminally differentiated B-lymphocytes that produces antibodies. B-cells
More informationRefractory M ultiple Multiple M yeloma Myeloma
Refractory Multiple Myeloma A Case Study Case: #1 48-Year-Old Male Presented to the ER with Fatigue and Acute Severe Lower Back Pain Patient assessment: X-ray of lumbar spine: L4 compression fracture,
More informationThe ABCs of Waldenström s Macroglobulinemia (WM)
The ABCs of Waldenström s Macroglobulinemia (WM) Jeffrey V. Matous MD Colorado Blood Cancer Institute IWMF Ed Forum May 2017 Objectives Describe the roots underneath WM Review incidence, possible risk
More informationBortezomib (Velcade)
Bortezomib (Velcade) Policy Number: Original Effective Date: MM.04.003 03/09/2004 Line(s) of Business: Current Effective Date: HMO; PPO; QUEST Integration 06/01/2015 Section: Prescription Drugs Place(s)
More informationNCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ) Multiple Myeloma
NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ) Version 4.2018 February 12, 2018 NCCN.org NCCN Guidelines for Patients available at www.nccn.org/patients Continue Version 4.2018, 02/12/18
More informationNCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ) Multiple Myeloma. NCCN Evidence Blocks. Version November 22, NCCN.
NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ) NCCN Evidence Blocks Version 3.2018 November 22, 2017 NCCN.org Continue Version 3.2018, 11/22/17 National Comprehensive Cancer Network,
More informationMultiple Myeloma: A Review of 92 Cases at King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
Multiple Myeloma: A Review of 92 Cases at King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia Salem H. Khalil, MB, BS; M. Andrew Padmos, BA(Hons), MD, FRCP(C); Peter Ernst MD, PhD;
More informationMyelodysplasia/Myeloproliferative Neoplasms (MDS/MPN) Post-HCT Data
Instructions for Myelodysplasia/Myeloproliferative Neoplasms (MDS/MPN) Post-HCT Data (Form 2114) This section of the CIBMTR Forms Instruction Manual is intended to be a resource for completing the Myelodysplasia/Myeloproliferative
More informationClinical Case Study Discussion: Maintenance in MM
www.comtecmed.com/comy comy@comtecmed.com Evangelos Terpos, MD, PhD National & Kapodistrian University of Athens, School of Medicine, Athens, Greece Clinical Case Study Discussion: Maintenance in MM Disclosure
More informationCase Report Biclonal IgD and IgM Plasma Cell Myeloma: A Report of Two Cases and a Literature Review
Case Reports in Hematology Volume 2013, Article ID 293150, 5 pages http://dx.doi.org/10.1155/2013/293150 Case Report Biclonal IgD and IgM Plasma Cell Myeloma: A Report of Two Cases and a Literature Review
More informationInteresting case seminar: Native kidneys Case Report:
Interesting case seminar: Native kidneys Case Report: Proximal tubulopathy and light chain deposition disease presented as severe pulmonary hypertension with right-sided cardiac dysfunction and nephrotic
More informationCASE 3 AN UNUSUAL CASE OF NEPHROTIC SYNDROME
CASE 3 AN UNUSUAL CASE OF NEPHROTIC SYNDROME Dr Seethalekshmy N.V., Dr.Annie Jojo, Dr Hiran K.R., Amrita institute of Medical Sciences, Kochi, Kerala Case history 34 year old gentleman Nephrotic range
More informationPersistence of Myeloma Protein for More than One Year after Radiotherapy Is an Adverse Prognostic Factor in Solitary Plasmacytoma of Bone
1532 Persistence of Myeloma Protein for More than One Year after Radiotherapy Is an Adverse Prognostic Factor in Solitary Plasmacytoma of Bone Richard B. Wilder, M.D. 1 Chul S. Ha, M.D. 1 James D. Cox,
More informationCASE REPORT Light chain multiple myeloma: an evaluation of its biochemical investigations
Malaysian J Pathol 2017; 39(3) : 311 315 CASE REPORT Light chain multiple myeloma: an evaluation of its biochemical investigations Siti Yazmin ZAHARI SHAM BM, MPath, Subashini C. THAMBIAH MBBS, MPath,
More informationHematology: Challenging Cases with Your Participation COPYRIGHT
Hematology: Challenging Cases with Your Participation Reed E. Drews, MD Beth Israel Deaconess Medical Center Harvard Medical School Boston, MA Question 1 Question 1 64-year-old man is evaluated during
More informationFreelite SFLC in CKD why use a different reference range? Dr Colin Hutchison Nephrologist Hawke s Bay DHB
Freelite SFLC in CKD why use a different reference range? Dr Colin Hutchison Nephrologist Hawke s Bay DHB Disclosures I have only really worked with the Freelite assays Previous research funding, technical
More informationI Need Treatment First-Line WM Treatments & Side Effects IWMF Educational Forum Grapevine, TX 5/1/2015
I Need Treatment First-Line WM Treatments & Side Effects IWMF Educational Forum Grapevine, TX 5/1/2015 Larry Anderson, MD, PhD Plasma Cell Disorder and Stem Cell Transplant Specialist UT Southwestern Medical
More informationNCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ) Multiple Myeloma
NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ) Version 3.2016 NCCN.org NCCN Guidelines for Patients available at www.nccn.org/patients Continue Version 3.2016, 01/15/16 National Comprehensive
More informationTYPE 1 GAUCHER DISEASE PRESENTING AS PERSISTENT THROMBOCYTOPENIA, ASSOCIATED FACTOR XI DEFICIENCY & EMERGENT MYELOMA
TYPE 1 GAUCHER DISEASE PRESENTING AS PERSISTENT THROMBOCYTOPENIA, ASSOCIATED FACTOR XI DEFICIENCY & EMERGENT MYELOMA Trish Hyland, Medical Scientist, Department of Haematology, Cork University Hospital
More informationManaging Myeloma Virtual Grand Rounds Newly Diagnosed, Transplant Eligible Patient. Case Study
Managing Myeloma Virtual Grand Rounds Newly Diagnosed, Transplant Eligible Patient Case Study 2 2011 Newly Diagnosed Patient The patient is a 61-year-old Caucasian female History of high blood pressure
More informationAmyloidosis: What to do and how to diagnose: An Update 2017
Amyloidosis: What to do and how to diagnose: An Update 2017 Jonathan L. Kaufman, MD Associate Professor Hematology & Oncology Winship Cancer Institute of Emory University Amyloidosis Protein Conformation/Deposition
More informationMM relaps efter min. 3 linie behandlinger.
Inklusionskriterier: Subjects must satisfy the following criteria to be enrolled in the study: 1. Subject is 18 years of age at the time of signing the informed consent form (ICF). 2. Subject must understand
More informationNew IMWG Response Criteria
New IMWG Response Criteria Shaji Kumar, M.D. Professor of Medicine Division of Hematology Mayo Clinic Scottsdale, Arizona Rochester, Minnesota Jacksonville, Florida Mayo Clinic College of Medicine Mayo
More informationCase 3. ACCME/Disclosure. Laboratory results. Clinical history 4/13/2016
Case 3 Lynn D. Cornell, M.D. Mayo Clinic, Rochester, MN Cornell.Lynn@mayo.edu USCAP Renal Case Conference March 13, 2016 ACCME/Disclosure Dr. Cornell has nothing to disclose Clinical history 57-year-old
More informationMichael Joffe ST6 Haematology SpR
Michael Joffe ST6 Haematology SpR Mrs SB 71 year old female on AMU Telephone referral to haematology by medicine with Hb 102 MCV 89, normal B12, Folate, Ferritin. PMH DM General decline over several weeks
More informationNCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ) Multiple Myeloma. Version NCCN.org. Continue
NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ) Version 1.2012 NCCN.org Continue Version 1.2012, 07/26/11 National Comprehensive Cancer Network, Inc. 2011, All rights reserved. The NCCN
More informationVelcade (bortezomib)
Velcade (bortezomib) Line(s) of Business: HMO; PPO; QUEST Integration Akamai Advantage Original Effective Date: 03/09/2004 Current Effective Date: 05/01/2017 POLICY A. INDICATIONS The indications below
More informationCase Study. Accidental Diagnosis of Multiple Myeloma in a 44-Year-Old White Woman due to Erroneous Results via Chemical Analyzers.
Accidental Diagnosis of Multiple Myeloma in a 44-Year-Old White Woman due to Erroneous Results via Chemical Analyzers Ola Bashiti, MLS(ASCP) CM Laboratory Medicine 47:1:5-11 CLINICAL HISTORY Patient: 44-year-old
More information