Management of Newly Diagnosed Symptomatic Multiple Myeloma: updated Mayo Stratification of Myeloma and Risk-Adapted Therapy (mSMART) Consensus Guidelines

Kumar, Shaji K.; Mikhael, Joseph R.; Buadi, Francis K.; Dingli, David; Dispenzieri, Angela; Fonseca, Rafael; Gertz, Morie A.; Greipp, Philip R.; Hayman, Suzanne R.; Kyle, Robert A.; Lacy, Martha Q.; Lust, John A.; Reeder, Craig B.; Roy, Vivek; Russell, Stephen J.; Short, Kristen E. Detweiler; Stewart, A. Keith; Witzig, Thomas E.; Zeldenrust, Steven R.; Dalton, Robert J.; Rajkumar, S. Vincent; Bergsagel, P. Leif

doi:10.4065/mcp.2009.0603

Cited by 628Multiple Myeloma Research and TreatmentsChronic Lymphocytic Leukemia ResearchBone health and treatments

Management of Newly Diagnosed Symptomatic Multiple Myeloma: updated Mayo Stratification of Myeloma and Risk-Adapted Therapy (mSMART) Consensus Guidelines

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Kumar, Shaji K., Mikhael, Joseph R., Buadi, Francis K., Dingli, David, Dispenzieri, Angela, Fonseca, Rafael, Gertz, Morie A., Greipp, Philip R. +14 more·2009·Mayo Clinic Proceedings

DOI 10.4065/mcp.2009.0603PMC PMC2787395

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Abstract

Multiple myeloma is a malignant plasma cell neoplasm that affects more than 20,000 people each year and is the second most common hematologic malignancy. It is part of a spectrum of monoclonal plasma cell disorders, many of which do not require active therapy. During the past decade, considerable progress has been made in our understanding of the disease process and factors that influence outcome, along with development of new drugs that are highly effective in controlling the disease and prolonging survival without compromising quality of life. Identification of well-defined and reproducible prognostic factors and introduction of new therapies with unique modes of action and impact on disease outcome have for the first time opened up the opportunity to develop risk-adapted strategies for managing this disease. Although these risk-adapted strategies have not been prospectively validated, enough evidence can be gathered from existing randomized trials, subgroup analyses, and retrospective studies to develop a working framework. This set of recommendations represents such an effort-the development of a set of consensus guidelines by a group of experts to manage patients with newly diagnosed disease based on an interpretation of the best available evidence.

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Disease biology is best reflected by molecular subtype and by secondary cytogenetic abnormalities such as del(17p), gain(1q), or del(1p).
“Disease biology best reflected based on the molecular subtype of multiple myeloma (Table 2), the presence or absence of secondary cytogenetic abnormalities such as del(17p), gain(1q), or del(1p).28,54”
From Multiple myeloma: 2024 update on diagnosis, risk-stratification, and management (2024) · cites this paper as [28]
The Risk Stratification of Newly Diagnosed MM section identifies genetic heterogeneity as a primary driver of disease course and discusses myeloma subgroups and the clinical relevance of del(17p). Our copy does not identify gain(1q) or del(1p) as examples, so it supports the general point but not the full list attributed to this source. (LLM, conf=0.85)
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[57]57. Greipp PR, Lust JA, O'Fallon WM, Katzmann JA, Witzig TE, Kyle RA. Plasma cell labeling index and b 2 -microglobulin predict survival indepen- For personal use. Mass reproduce only with permission from Mayo Clinic Proceedings a . couraging efficacy in high risk groups with updated results of a phase I/II study. [abstract 92]. Blood (ASH Annual Meeting Abstracts). 2008;112:92.
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Authors: Kumar, S. K., Mikhael, J. R., Buadi, F. K., Dingli, D., Dispenzieri, A., Fonseca, R., Gertz, M. A., Greipp, P. R., Hayman, S. R., Kyle, R. A., Lacy, M. Q., Lust, J. A., Reeder, C. B., Roy, V., Russell, S. J., Short, K. E. D., Stewart, A. K., Witzig, T. E., Zeldenrust, S. R., Dalton, R. J., Rajkumar, S. V., & Bergsagel, P. L.
Affiliations: Mayo Clinic (US)
Mayo Clinic in Arizona (US)
Corresponding author: Kumar, Shaji K.
ORCID: Kumar, Shaji K.
Mikhael, Joseph R.
Buadi, Francis K.
Dingli, David
Dispenzieri, Angela
Gertz, Morie A.
Hayman, Suzanne R.
Kyle, Robert A.
Lacy, Martha Q.
Reeder, Craig B.
Roy, Vivek
Russell, Stephen J.
Witzig, Thomas E.
Rajkumar, S. Vincent
Bergsagel, P. Leif
Venue: Mayo Clinic Proceedings
Publisher: Elsevier BV
Published: 2009-12
Volume: 84
Issue: 12
Pages: 1095-1110
ISSN: 0025-6196 (ISSN-L)
DOI: 10.4065/mcp.2009.0603
PMC: PMC2787395
OpenAlex: W2040925557
Semantic Scholar: 424cd4790a2003a5a4a4baad22acf18f761865bc
Cited by: 628
References: 177
Citations by year: 2026: 6 · 2025: 17 · 2024: 18 · 2023: 46 · 2022: 31 · 2021: 41 · 2020: 46 · 2019: 38 · 2018: 37 · 2017: 46 · 2016: 53 · 2015: 48 · 2014: 46 · 2013: 58 · 2012: 40
FWCI: 20.82
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Mayo Clinic Proceedings (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: National Cancer Institute
Topics: Health Sciences › Medicine › Hematology › Multiple Myeloma Research and Treatments
Health Sciences › Medicine › Genetics › Chronic Lymphocytic Leukemia Research
Health Sciences › Medicine › Oncology › Bone health and treatments
Keywords: multiple myeloma, newly diagnosed multiple myeloma, risk-adapted treatment, prognostic factors, risk stratification, treatment selection, monoclonal plasma cell disorder, consensus recommendations
MeSH terms: Antineoplastic Combined Chemotherapy Protocols, Humans, Multiple Myeloma, Biomarkers, Tumor, Practice Guidelines as Topic, Risk Assessment, Stem Cell Transplantation

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Management of Newly Diagnosed Symptomatic Multiple Myeloma: updated Mayo Stratification of Myeloma and Risk-Adapted Therapy (mSMART) Consensus Guidelines

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