Welcome to Managing Myeloma, I am Dr. Philip McCarthy. Today, I would like to discuss the current standard of care for follow-up monitoring of patients diagnosed with smoldering myeloma. In the past, patients had been seen sometimes somewhat infrequently, but we now think it is the standard that these patients should be seen approximately every three months to have their serum levels checked, to make sure that their serum-free light chains and their monoclonal proteins are not changing over time. We also want to make sure that they do not develop anemia or have laboratory tests that would indicate the patient is now developing progression to myeloma. This is because we found in the past that if patients were to progress to renal failure, or hypercalcemia, or develop paraspinal lesions that would require surgery or radiation, it became much more medically complicated to manage them, and we would end up potentially with permanent end organ damage. These patients need to be followed very carefully, with a low threshold for doing a more extensive workup to make sure that nothing has changed. In addition, they should be monitored by some imaging modality to make sure that they have not developed occult lytic lesions that have not yet presented pain. These are the important issues in managing patients who are not receiving therapy but who are at higher risk because they have smoldering myeloma. Thank you very much for viewing this activity.
NCCN Guidelines (free registration/log-in required) https://www.nccn.org/store/login/login.aspx?ReturnURL=https://www.nccn.org/professionals/physician_gls/pdf/myeloma.pdf