Guidelines on the Diagnosis and Management of Multiple Myeloma

British Committee for Standards in Haematology

Table of Contents

Compiled by the Guidelines Working Group of the UK Myeloma Forum on behalf of the British Committee for Standards in Haematology (BCSH) - a sub-committee of the British Society for Haematology (BSH):

Completion date: 24th July 2001
Published on UKMF website: 8th August 2001
Most recent minor revision: 10th March 2003 [Bisphosphonates 2002 revision]

Planned full revision date July 2004; interim updates will be published on the UKMF and BSH/BCSH web-sites, as they occur.

Working and compiling group:

  • Dr. Alastair Smith (Chairman), Southampton University Hospitals NHS Trust
  • Dr. Judith Behrens, St. Helier Hospital NHS Trust, Carshalton, Surrey
  • Dr. Mark Drayson, University of Birmingham
  • Dr. Neil Iggo, Brighton Healthcare NHS Trust
  • Dr. Graham Jackson, Royal Victoria Infirmary, Newcastle upon Tyne
  • Mr. Eric Low, International Myeloma Foundation (UK)
  • Dr. Atul Mehta, Royal Free Hospital, London
  • Ms. Julia Liddi, CancerBACUP UK
  • Dr. Steve Schey, Guys and St Thomas NHS Trust London
  • Dr. Charles Singer, Royal United Hospitals NHS Trust, Bath
  • Dr. Diana Samson, Faculty of Medicine, Imperial College, London (Chairman UK Myeloma Forum)
  • Dr. Richard Soutar, Western Infirmary, Glasgow

Additional consultation and advice:

  • Dr Stuart Ralston, Dept of Medicine, Aberdeen Royal Infirmary on behalf of the Bone and Tooth Society
  • Dr Tim Illidge, Dept of Clinical Oncology, Southampton University Hospitals NHS Trust

Produced with the support of an educational grant from the International Myeloma Foundation (UK).

Table of Contents

  1. Methods
    • Levels of Evidence
    • Grades of Recommendation
  2. Myeloma - context
    • Epidemiology and Incidence
    • Clinical Presentation
    • Appropriate Setting for the Management of Myeloma
  3. Diagnosis, Investigation and Indications for Treatment
    • Diagnosis and Investigation
    • Indications for Starting Therapy
  4. General Measures and Supportive Care
  5. Initial Chemotherapy and Transplantation
    • Melphalan with or without prednisolone
    • Cyclophosphamide with or without prednisolone
    • Alkylator-based Combination Chemotherapy Regimens
    • VAD and related Regimens
    • High Dose Dexamethasone (HDD)
    • High dose Therapy (HDT) with Autologous Stem Cell Transplant (ASCT)
    • Allogeneic Transplantation
  6. Interferon
    • Induction
    • Maintenance
    • Relapsed and refractory disease
    • Side effects
    • Conclusion
  7. Bisphosphonates
  8. Management of Relapsed and Refractory Disease
    • Primary Refractory Disease
    • Relapsed / progressive disease
  9. The Management of Patients With Renal Failure
    • Early Treatment
    • Choice of Chemotherapy Regimen
    • General points in management
    • Later Treatment
  10. Patient Information and Support
    • Key recommendations
    • Useful information sources
  11. Appendix: Minimum Data Set for Myeloma
    • Registration Data
    • Follow Up Data
  12. References

 

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