UKMF Guidelines Group Report 2001-2002
Dr Alastair Smith, Consultant Haematologist, Southampton General Hospital, Southampton S016 6DY
Publication of UK Myeloma Forum Guidelines
The final format of the guidelines was agreed with the BCSH & BSH in July 2001 after review by the BSH sounding board. Issues regarding publication were similarly resolved at that time. The guidelines were published in the British Journal of Haematology in December (115, 522-40; 2001). They were also released in virtually identical text format shortly before the Brit J Haem publication on the Forum website. in Leeds has undertaken a fantastic job in preparing the material for the web-site - the guidelines are a much visited part of the Forum website.
Feedback has been generally very good; we have also been approached for permission to translate them into Czech. Circulation of reprints has been undertaken to UKMF members, Colleges & Networks, etc.
Updating plans
These are in hand. Designated members of the guidelines group have reviewed key literature on specific topics. The committee will review the updating recommendations & co-ordinate the process appropriately.
NICE stakeholder status
The UKMF now registered as a stakeholder for Haematological Malignancy and Supportive & Palliative Care in relation to the NICE process.
"Refreshed" group
New members have joined the group from the forum. Wherever possible work is done electronically although there are 2-3 "core" meetings pa.
Current Plans/Work
Plasmacytoma: Once agreement has been reached with the BCSH/BSH the objective is to produce a guideline for investigation, management and follow up of plasmacytoma. A core working group remains to be finalised (which will include Clinical Oncologists) with the aim of producing the first draft for review/sounding boards within 6 months.
Amyloidosis: as for plasmacytoma.
Patient version of guidelines: This is in the process of drafting by IMF(UK) and key patient advocacy groups in consultation with the guidelines group.
GP version of guidelines A version orientated at primary care is similarly in the later stages of drafting for review by appropraite GP professional bodies - focus will be on referral and involvement in ongoing care of the MM patient.
Infection prevention/management: Literature is uninformative and generally data free on best practice in relation to infection prevention and mangement. There is wide variation in approaches across the UK, supported by findings from a pilot audit carried out in W Midlands by Supratik Basu. The group proposes to review existing practices and develop some practical concensus guidelines/recommendations.
Imaging: As in infection there is a lack of data on basic imaging, e.g. the nature of a skeletal survey and report quality standards. The group is seeking Radiology contacts with the aim of producing concensus and/or data based guidelines on imaging techniques and their application and interpretation in myeloma.
Diagnosis/staging: We await the report from the International working group on this topic; once available it should be then possible to produce guidelines in Monoclonal Gammopathies.
Financial Support: The IMF (UK) have elected to retain a core fund to support guidelines and education work in relation to Myeloma and related disorders.