Welcome to Managing Myeloma. My name is Sergio Giralt, and I am the Melvin Berlin Family Chair of Myeloma Research at Memorial Sloan Kettering Cancer Center. I am also a Professor of Medicine at Weill Cornell Medical College, and the Chief of the Adult BMT Service at Memorial Hospital in New York City.
I am frequently asked what the new NCCN/IMWG recommended baseline workup tests are for multiple myeloma. It is essential that all newly diagnosed patients with multiple myeloma have a complete workup, 1) to determine organ involvement, 2) to determine staging, and 3) to determine prognosis. This will allow for the best risk stratification for an individual patient, so we can provide the best care at the initial moment of diagnosis. Currently, we are recommending:
- Medical history
- Bone marrow aspiration and biopsy
- Complete laboratory examination with CBC
- Platelet count and iron studies
- Metabolic evaluation with calcium
- Renal function tests
- Liver function tests
- Skeletal survey with also the new enhanced x-rays, such as PET-CT, or whole body MRI
It is essential that we also include:
- Immunoglobulin levels
- Free light chain assays
- Quantitative immunoglobulins
- Protein electrophoresis
- Cytogenetics on the bone marrow
- Free light chain assay
In the bone marrow, it is essential that we include cytogenetic analysis for both FISH and conventional cytogenetics, or karyotypic analysis. It is unfortunate that still today, only 60-70% of both academic and community centers are actually ordering all the tests necessary for an appropriate staging and evaluation of a newly diagnosed myeloma patient. Activities such as this, on Managing Myeloma, are aimed to improve the quality of care that is provided to myeloma patients in the community, in the academic centers, and even in the centers of excellence for myeloma.
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Please view the Updated Criteria for the Diagnosis of Multiple Myeloma.