14191
2015
eng
1254
1266
10
100
article
European Myeloma Network
1
2016-12-16
--
--
European Myeloma Network Guidelines for the Management of Multiple Myeloma-related Complications
The European Myeloma Network provides recommendations for the management of the most common complications of multiple myeloma. Whole body low-dose computed tomography is more sensitive than conventional radiography in depicting osteolytic disease and thus we recommend it as the novel standard for the detection of lytic lesions in myeloma (grade 1A). Myeloma patients with adequate renal function and bone disease at diagnosis should be treated with zoledronic acid or pamidronate (grade 1A). Symptomatic patients without lytic lesions on conventional radiography can be treated with zoledronic acid (grade 1B), but its advantage is not clear for patients with no bone involvement on computed tomography or magnetic resonance imaging. In asymptomatic myeloma, bisphosphonates are not recommended (grade 1A). Zoledronic acid should be given continuously, but it is not clear if patients who achieve at least a very good partial response benefit from its continuous use (grade 1B). Treatment with erythropoietic-stimulating agents may be initiated in patients with persistent symptomatic anemia (hemoglobin < 10g/dL) in whom other causes of anemia have been excluded (grade 1B). Erythropoietic agents should be stopped after 6-8 weeks if no adequate hemoglobin response is achieved. For renal impairment, bortezomib-based regimens are the current standard of care (grade 1A). For the management of treatment-induced peripheral neuropathy, drug modification is needed (grade 1C). Vaccination against influenza is recommended; vaccination against streptococcus pneumonia and hemophilus influenza is appropriate, but efficacy is not guaranteed due to suboptimal immune response (grade 1C). Prophylactic aciclovir (or valacyclovir) is recommended for patients receiving proteasome inhibitors, autologous or allogeneic transplantation (grade 1A).
Haematologica
10.3324/haematol.2014.117176
urn:nbn:de:bvb:20-opus-141913
Haematologica 2015; 100(10), pp. 1254-1266. doi:10.3324/haematol.2014.117176
Deutsches Urheberrecht
Evangelos Terpos
Martina Kleber
Monika Engelhardt
Sonja Zweegman
Francesca Gay
Efstathios Kastritis
Niels W. C. J. van de Donk
Benedetto Bruno
Orhan Sezer
Annemiek Broijl
Sara Bringhen
Meral Beksac
Alessandra Larocca
Roman Hajek
Pellegrino Musto
Hans Erik Johnsen
Fortunato Morabito
Heinz Ludwig
Michele Cavo
Hermann Einsele
Pieter Sonneveld
Meletios A. Dimopoulos
Antonio Palumbo
eng
uncontrolled
bone-disease
eng
uncontrolled
stem-cell transplantation
eng
uncontrolled
acute kidney injury
eng
uncontrolled
erythropoiesis-stimulating agents
eng
uncontrolled
recombinant-human-erythropoietin
eng
uncontrolled
randomized controlled trial
eng
uncontrolled
group consensus statement
eng
uncontrolled
newly-diagnosed myeloma
eng
uncontrolled
zoledonic acid
eng
uncontrolled
enal impairment
Medizin und Gesundheit
open_access
Medizinische Klinik und Poliklinik II
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/14191/Terpos_Haematologica.pdf
11605
2014
eng
984 - 996
6
99
article
1
2015-07-16
--
--
The clinical relevance and management of monoclonal gammopathy of undetermined significance and related disorders: recommendations from the European Myeloma Network
Monoclonal gammopathy of undetermined significance is one of the most common pre-malignant disorders. IgG and IgA monoclonal gammopathy of undetermined significance are precursor conditions of multiple myeloma; light-chain monoclonal gammopathy of undetermined significance of light-chain multiple myeloma; and IgM monoclonal gammopathy of undetermined significance of Waldenstrom's macroglobulinemia and other lymphoproliferative disorders. Clonal burden, as determined by bone marrow plasma cell percentage or M-protein level, as well as biological characteristics, including heavy chain isotype and light chain production, are helpful in predicting risk of progression of monoclonal gammopathy of undetermined significance to symptomatic disease. Furthermore, alterations in the bone marrow microenvironment of monoclonal gammopathy of undetermined significance patients result in an increased risk of venous and arterial thrombosis, infections, osteoporosis, and bone fractures. In addition, the small clone may occasionally be responsible for severe organ damage through the production of a monoclonal protein that has autoantibody activity or deposits in tissues. These disorders are rare and often require therapy directed at eradication of the underlying plasma cell or lymphoplasmacytic clone. In this review, we provide an overview of the clinical relevance of monoclonal gammopathy of undetermined significance. We also give general recommendations of how to diagnose and manage patients with monoclonal gammopathy of undetermined significance.
Haematologica
10.3324/haematol.2013.100552
0390-6078
24658815
urn:nbn:de:bvb:20-opus-116050
Haematologica 2014 9(6), p. 984-996. doi 10.3324/haematol.2013.100552
Deutsches Urheberrecht
Niels W. C. J. van de Donk
Antonio Palumbo
Hans Erik Johnsen
Monika Engelhardt
Francesca Gay
Henrik Gregersen
Roman Hajek
Martina Kleber
Heinz Ludwig
Gareth Morgan
Pellegrino Musto
Torben Plesner
Orhan Sezer
Evangelos Terpos
Anders Waage
Sonja Zweegman
Hermann Einsele
Pieter Sonneveld
Henk M. Lokhorst
eng
uncontrolled
multiparameter flow-cytometry
eng
uncontrolled
hematopoietic cell transplantation
eng
uncontrolled
smoldering multiple-myeloma
eng
uncontrolled
venous thromboembolic disease
eng
uncontrolled
bone-mineral density
eng
uncontrolled
population-based cohort
eng
uncontrolled
term-follow-up
eng
uncontrolled
marrow plasma cells
eng
uncontrolled
significance MGUS
eng
uncontrolled
malignant transformation
Medizin und Gesundheit
open_access
Medizinische Klinik und Poliklinik II
Universität Würzburg