Multiple Myeloma Treatment Guidelines

Multiple Myeloma Treatment Guidelines
Multiple myeloma treatment guidelines - Guidelines the International working group for myeloma in 2014 for standard investigative work in patients with suspected multiple myeloma include the following studies:
  • Evaluation of serum and urine for monoclonal protein (crawl densitometric and quantification nephelometric, immunofixation for confirmation)
  • Serum analysis easy easy circuit (all patients with newly diagnosed disclosee plasma cells)
  • The bone marrow aspiration and / or biopsy
  • Serum beta2-microglobulin, albumin, serum immunoglobulins, and measurement of lactate dehydrogenase (LDH)
  • Standard metaphase cytogenetics
  • Fluorescence in situ hybridization (FISH)
  • Skeletal survey
  • Magnetic resonance imaging (MRI), foreachelse-positron emission tomography (FDG-PET) or low doses of whole body CT scan for better detection of bone and extramedullary disease

Current guidelines for clinical practice within the national comprehensive cancer network (NCCN) multiple myeloma is also recommended to use FISH for 1q21 amplification as part of the initial diagnostic work.

Multiple Myeloma Treatment Guidelines: Diagnostic Criteria

Multiple myeloma is defined as ardent (asymptomatic) or active (symptomatic). The criteria for submitting multiple myeloma without burning are the following:
  • M-protein in serum: IgG ≥3 g / DL, IgA> 1 g / DL or
  • Protein Benson-Jones> 1 g / 24 h and / or
  • Clonal plasma cells of the bone marrow ≥10%

Active multiple myeloma was diagnosed using the CRAB criteria (hypercalcemia, renal insufficiency, anemia, bone lesions) for organ damage in front of the bodies, namely:
  • Calcium> 11.5 mg / DL (> 2.65 mmol / l)
  • Creatinine> 2 mg / DL (177 µmol / l or more)
  • Hemoglobin <10 g / DL or 2 g / DL <normal (<12.5 mmol / l <normal)
  • Lytic or osteopenic bone disease

However, in November 2014, the international working group on myeloma added the following criteria for multiple myeloma that would require therapy:
  • Plasma bone marrow cells (BMPC) ≥60%
  • Interdependent / separation of the serum free light chain ratio ≥100
  • Abnormal MRI with more than one focal lesion with each lesion> 5 mm

International working group noted that these data were "linked to the almost inevitable development of CRAB features in patients who otherwise would be considered smoldering multiple myeloma". The Presence of any of the CRAB criteria or any of the three additional Criteria justify therapy.

Guidelines for the Treatment of Multiple Myeloma

Multiple myeloma treatments: Guidelines for the treatment of multiple myeloma Foundation multiple myeloma research provides detailed information about the different types of myeloma treatment, surgery or therapy.

Thanks to advances in cancer research number of treatment options available for multiple myeloma patinov increased significantly, which greatly improved the life expectancy of myeloma. Patients and patients ' families can learn everything from what bisphosphonates are different types of stem cell transplantation. It is important to note that the most important part of the evaluation of your treatment options multiple myeloma is to talk with your doctor. Multiple myeloma often varies depending on the stage of your myeloma and prognosis. In our recommendations focus on seven areas that can take into account patients with myeloma (and families) in the study of different treatment options:

Bisphosphonates
Bisphosphonates are a type of treatment drug that helps the bones to stay strong, preventing exposure of multiple myeloma. 85% of patients with multiple myeloma experience some problems with the bone, bisphosphonates help these patients:
  • Slowing of bone tissue
  • Reducing pain in the bones
  • Reducing the risk of bone fractures

All patients with symptoms of multiple myeloma, should receive a monthly intravenous injection bisphosphonate.

Growth Factors
Growth factors are drugs that are used to stimulate the production of red blood cells. There are two main forms of growth factors:
  • Erythropoietin (EPO)
  • Factors that increase colony (CSF)

Erythropoietin works by stimulating the production of red blood cells, while colony-stimulating factors stimulate the production of white blood cells associated with infection.

Surgery orthopedic Surgery
Orthopedic surgical interventions help to control bone pain or to maintain bone function or mobility for patients with myeloma. Almost 75% of patients with multiple myeloma experience bone pain, so for patients it is important to understand the available surgical options. 2 orthopaedic surgery for patients with myeloma include vertebroplasty or kyphoplasty. Both operations on the bones is a minimally invasive procedure that provides several benefits for patients with myeloma suffering from bone pain or bone complications.

Radiation Therapy
Radiation therapy, also known as radiotherapy or x-ray therapy is a treatment that uses particles (radiation) high energy to damage by myeloma cells or prevent their growth. There are different types of radiotherapy depending on how well developed the disease. Radiation therapy includes:
  • Local radiation
  • High-dose radiation
  • Local low dose
  • Total body irradiation

Radiation treatments cause many side effects, the most common are fatigue, loss of appetite or sensitive skin.

Stem cell transplantation
Stem cell transplantation is a treatment option for multiple myeloma patients who are after high-dose chemotherapy. High-dose chemotherapy destroys important cells called hematopoietic stem cells, which help to produce red blood cells. Stem cell transplantation helps patients to restore these hematopoietic stem cells. Patients end up unable to continue the production of red blood cells thanks to stem cell transplant.

Treatment side Effects
Side effects vary greatly depending on different treatment options. For example, patients undergoing chemotherapy usually experience hair loss, and patients undergoing radiation therapy usually experience sensitive skin.

Treatment for the Symptoms
There are some common symptoms that are experienced by most patients with myeloma. These patients have at their disposal a variety of treatment options that can reduce the severity of these symptoms. For example, patients with anemia can taking the Supplement with a high content of iron, folate or vitamin B-12. On the other hand, patients with the problem of bone can consider the use of bisphosphonates or orthopedic surgery.
For more information about several methods of treatment for myeloma consult your doctor. Myeloma patients can also learn about different drugs or experimental myeloma treatment options multiple myeloma that are available today by visiting other sections of our knowledge centre.