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.
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.