Two Onc Docs Multiple Myeloma 2025 x Dr. Vincent Rajkumar Part 1
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Feb 3, 2025 This week, Dr. Vincent Rajkumar, a leading expert in multiple myeloma from the Mayo Clinic, shares his insights into this complex condition. He covers vital topics like the common symptoms, including bone lesions and anemia, and explains the SLIM-CRAB diagnostic criteria. Dr. Rajkumar discusses the prevalence of M proteins, risk factors, and the disparities in diagnosis related to race. He also unpacks treatment strategies, emphasizing the significance of minimal residual disease (MRD) and personalized approaches to maintenance therapy.
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Multiple Myeloma Presentation
- Multiple myeloma often presents with lytic bone lesions causing pain and fractures.
- Other symptoms include renal failure, anemia, and infections.
Multiple Myeloma Diagnostic Criteria
- The diagnostic criteria for multiple myeloma includes evidence of clonal plasma cell disorder and CRAB features (hypercalcemia, renal failure, anemia, bone lesions).
- Additional biomarkers include >60% clonal plasma cells, serum-free light chain ratio ≥100, and two or more focal lesions on MRI (SLIM-CRAB).
Multiple Myeloma Workup
- Evaluate suspected plasma cell dyscrasias with CBC, serum calcium, creatinine, and bone imaging (CT or PET CT).
- Include specialized tests like SPEP, serum immunofixation, serum-free light chain assay, 24-hour urine PEP, bone marrow biopsy, and cytogenetics.