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Cause And Symptoms

Complications

Diagnosis And Treatment

Overview

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References

multiple-myeloma

Multiple Myeloma

Renal impairment is a common complication in patients with multiple myeloma

Patients with renal impairment are o en excluded from or underrepresented in clinical trials1

...and it forms a core part of the&nbsp;CRAB criteria&nbsp;used to diagnose multiple myeloma2,3

Depth of renal impairment at diagnosis is predictive of poor prognosis6
eGFR (mL/min/1.73m²)

MULTIPLE-MYELOMA

HEMATOLOGY

Multiple Myeloma: Renal Impairment

Patients with multiple myeloma who achieve minimal residual disease (MRD) negativity have been shown to have better outcomes compared with MRD positive patients1

Achieving deeper responses can improve outcomes2

Sustained MRD– = MRD– for 1 year

MRD is the low level of malignant cells that persist even after a complete response with myeloma treatment1

<h2>The methods used for determining MRD negativity include:</h2>

<h2>Achieving MRD negativity is associated with better outcomes such as longer PFS and OS compared with patients who are MRD positive6,7</h2>

<h2>MRD negativity is being considered as a regulatory surrogate endpoint for PFS8,9</h2>

Abbreviations

Multiple Myeloma: Minimal Residual Disease

<h2>MULTIPLE MYELOMA: CYTOGENETIC ABNORMALITIES</h2>
The presence of high-risk cytogenetic features has been well documented as a negative prognostic factor and these patients typically have poorer outcomes compared with standard risk patients1,2

Genomic instability and heterogeneity are hallmarks of multiple myeloma1,6

<h3>Multiple myeloma: cytogenetic abnormalities1,6,12</h3>

<h2>Cytogenetic analysis of bone marrow samples by fluorescence in situ hybridization (FISH) is recommended at diagnosis for risk stratification1,13,14</h2>
The IMWG use the following cytogenetic abnormalities identified by FISH to define multiple myeloma with poor prognosis:1

*Included in the Revised International Staging System for multiple myeloma as high-risk15

<h2>Gain of chromosome 1q is commonly found in patients with MM and frequency increases with disease progression16</h2>
Gain 1q is a poor prognostic factor with a negative impact on survival outcomes particularly when there are more than&nbsp;4 copies&nbsp;present or if it is associated with other high-risk cytogenetic abnormalities

<table border="1" cellpadding="10" cellspacing="1" style="width:100%;">
 <tbody>
 <tr>
 <td>There is inconsistency in clinical trials in the cut-o used to define the existence of a high-risk abnormality ranging from detection in a single cell to 60% of cells4,5</td>
 </tr>
 </tbody>
</table>
A clear definition of a high-risk diagnosis is needed

<h2>Response rates and survival outcomes are lower for patients with genetic abnormalities versus those with standard risk cytogenetics2,17</h2>

Multiple Myeloma

Latest Articles

Multiple Myeloma: Renal Impairment

Multiple Myeloma: Minimal Residual Disease

Multiple Myeloma: High Risk Cytogenetics