MULTIPLE MYELOMA: ETIOPATHOGENESIS, STAGING, DIAGNOSIS, TREATMENT AND RESPONSE ASSESSMENT

Helan Kurian*, Suja Abraham, Arpith Antony, Jeeva A. Jiju, Timy Thomas

ABSTRACT

Multiple myeloma (MM), also known as Kahler’s disease is an incurable haematological malignancy (plasma cell dyscrasia) of clonal B – cells of the plasma cells (a type of white blood cells in the bone marrow). Approximately 6.5% per lakh population are affected with multiple myeloma and is the second most common haematological malignancy. According to Indian Council of Medical Research (ICMR), in 2017 the global burden of MM has increased uniformly in the last 30 years and the global prevalence of MM accounts to 10,000 new cases every year in 1.4% per lakh population. The exact cause of MM is not established. Studies showed that, various factors contribute to the etiology of MM, such as genetic causes, environmental or occupational causes and Monoclonal Gammopathy of Undefined Significance (MGUS) or Smoldering MM (SMM). The first and foremost treatment goals of MM is to achieve a deep and long lasting clinical response, control of malignant cell growth and its spreading, to reduce complications of MM and to improve the quality of life in these patients. The selection of treatment regimen is completely patient specific and depends upon the baseline characteristics of the patient such as cytogenetic, disease stage, age, comorbidities and performance status of the patient. Multiple myeloma response criterias are used for determining the disease status for multiple myeloma and solitary plasmacytomas. To report the Stringent Complete Response (sCR) or Complete Response (CR), the urine studies are performed and should fulfil the International Myeloma Working Group (IMWG) criteria.

Keywords: multiple myeloma, response assessment, smoldering multiple myeloma, duries- salmon staging.