![]() Recently the foundation of these recommendations have been challenged considering the low rate of progression and potential harm related to over-testing.Īs MM remains an incurable disease, a timely diagnosis is crucial to establish an adequate plan of care and potentially prevent significant comorbidities such as pathologic fractures or kidney failure. Lifelong annual medical evaluation and blood testing are currently recommended as a mean to early diagnose progression into asymptomatic (smoldering) or active MM. While in most outpatient encounters the paraprotein is non pathogenic and cannot explain the presenting symptoms, both patients and physicians are faced with the medical, psychological and economic consequences of a premalignant diagnosis that is non curable, and the obligation (or lack thereof) for follow up. It is generally an incidental diagnosis during the evaluation of patients complaining of various symptoms such as fatigue, forgetfulness, or neuropathy. MGUS occurs in around 3% of people older than 50 and is associated with a lifelong, low, yet non negligible, risk of progression to multiple myeloma (MM) or a related plasma cell dyscrasia. Poorly controlled health conditions, such as diabetes or heart disease, for example, can predict a worse prognosis.A monoclonal spike (M spike or paraprotein) on serum protein electrophoresis (SPEP) is a frequent finding in the general population and typically is pathognomonic of an asymptomatic, premalignant condition called monoclonal gammopathy of undetermined significance (MGUS). Overall health can affect the outlook of someone with myeloma. In the studies of the international staging system, older people with myeloma do not live as long. When they are damaged by the monoclonal immunoglobulin, blood creatinine levels rise, predicting a worse outlook. Kidneys eliminate this chemical from the body. The blood creatinine level shows how healthy the kidneys are. Other chromosome abnormalities are considered standard risk or not high risk.Ĭancer staging can be complex, so ask your doctor to explain it to you in a way you understand.įactors other than stage that affect survival Kidney function These 3 specific chromosome changes are considered high risk. ![]() A translocation involving chromosomes 14 and 16 is also linked to a poorer outcome. Another genetic abnormality that predicts a poor outcome is an exchange of material from chromosomes 4 and 14. For example, loss of a piece of chromosome 17 is linked to a poorer outcome. Certain chromosome changes can mean a poorer outlook. This test may also be called cytogenetics. *The bone marrow may be sent for tests to look at the chromosomes in the cancer cells. Serum beta-2 microglobulin is 5.5 (mg/L) or greater ![]() Serum beta-2 microglobulin is less than 3.5 (mg/L)Ĭytogenetics are considered “not high risk” * The specific gene abnormalities (cytogenetics) of the cancer.The amount of beta-2-microglobulin in the blood.Multiple myeloma is staged using the Revised International Staging System (RISS) based on 4 factors: Doctors also use a cancer's stage when talking about survival statistics. It helps determine how serious the cancer is and how best to treat it. The stage of a cancer describes how much cancer is in the body. After someone is diagnosed with cancer, doctors will try to figure out if it has spread, and if so, how far. ![]()
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