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Multiple myeloma: clinical features and indications for therapy
Angela Dispenzieri1, Robert A Kyle
1Mayo Clinic, Rochester, MN 55905, USA. dispenzieri.angela@mayo.edu
Best Practice & Research. Clinical Haematology
|July 20, 2005
Summary
Multiple myeloma is a serious cancer affecting plasma cells. Early recognition of its spectrum, from MGUS to active disease, is crucial for effective patient management and treatment.
Area of Science:
- Hematology
- Oncology
Background:
- Multiple myeloma is a significant plasma-cell malignancy.
- It represents 1% of all cancers and a higher percentage of hematologic malignancies, particularly in African Americans.
- Diagnosis involves bone pain, anemia, and bone marrow plasma cell infiltration.
Purpose of the Study:
- To highlight the importance of recognizing the spectrum of plasma-cell proliferative disorders.
- To emphasize how distinctions between MGUS, SMM, and active MM impact management.
- To differentiate multiple myeloma from related conditions like amyloidosis and POEMS syndrome.
Main Methods:
- Review of diagnostic criteria for multiple myeloma.
- Classification of plasma-cell proliferative disorders.
- Comparison of clinical features and management implications.
Main Results:
- The spectrum includes monoclonal gammopathy of undetermined significance (MGUS), smoldering (asymptomatic) multiple myeloma (SMM), and active (symptomatic) MM.
- Accurate diagnosis influences critical management decisions.
- Related disorders such as primary systemic amyloidosis, POEMS syndrome, and acquired Fanconi syndrome are distinct entities.
Conclusions:
- Distinguishing between different plasma-cell proliferative disorders is essential for appropriate patient care.
- Understanding the full spectrum aids in therapeutic strategy development.
- Early identification and classification are key to managing multiple myeloma and related conditions effectively.