Multiple myeloma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
Moreau P (1), San Miguel J (2), Sonneveld P (3), Mateos MV (4), Zamagni E (5), Avet-Loiseau H (6), Hajek R (7), Dimopoulos MA (8), Ludwig H (9), Einsele H (10), Zweegman S (11), Facon T (12), Cavo M (5), Terpos E (8), Goldschmidt H (13), Attal M (6), Buske C (14); ESMO Guidelines Committee.
(1) Haematology Department, University Hospital Hôtel-Dieu, Nantes, France.
(2) Clinica Universidad de Navarra, CIMA, IDISNA, Pamplona, Spain.
(3) Erasmus Medical Center Institute, Rotterdam, The Netherlands.
(4) University Hospital of Salamanca, IBSAL, Salamanca, Spain.
(5) Seragnoli Institute of Hematology, School of Medicine, Bologna University, Bologna, Italy.
(6) The Cancer Research Center of Toulouse, CRCT, INSERM U 1037, Toulouse, France.
(7) Faculty of Medicine, University Hospital Ostrava, Ostrava, Czech Republic.
(8) Department of Clinical Therapeutics, School of Medicine, University of Athens, Athens, Greece.
(9) Wilhelminen Cancer Research Institute, Wilhelminenspital, Vienna, Austria.
(10) Department of Internal Medicine II, University Hospital Wuerzburg, Wuerzburg, Germany.
(11) Department of Hematology, VU University Medical Center, Amsterdam, The Netherlands.
(12) University Hospital Huriez, Lille, France.
(13) Department of Medicine, University of Heidelberg, Heidelberg.
(14) Comprehensive Cancer Center Ulm and Department of Internal Medicine III, Institute of Experimental Cancer Research, University Hospital, Ulm, Germany.
Multiple myeloma (MM) accounts for 1% of all cancers and ∼10% of all haematological malignancies.
The incidence in Europe is 4.5–6.0/100 000/year with a median age at diagnosis of 72 years; the mortality is 4.1/100 000/year. Almost all patients with MM evolve from an asymptomatic pre-malignant stage termed monoclonal gammopathy of undetermined significance (MGUS). MGUS progresses to MM at a rate of 1% per year.
In some patients, an intermediate asymptomatic but more advanced pre-malignant stage termed smouldering (or indolent) MM (SMM) can be recognised. SMM progresses to myeloma at a rate of 10% per year over the first 5 years following diagnosis, 3% per year over the following 5 years, and 1.5% per year thereafter.
CITATION Ann Oncol. 2017 Apr 27. doi: 10.1093/annonc/mdx096