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Mayo Clinic hævdes fra mange sider at sikre væsentligt bedre overlevelse for sammenlignelige patientgrupper. De tager i høj grad udgangspunkt i FISH analysen.
Multiple myeloma is increasingly recognized as more than one disease, characterized by marked cytogenetic, molecular, and proliferative heterogeneity.
• The result is widely varied outcome ranging from low to very high risk.
• Treatment is evolving rapidly as more effective agents and combinations
• mSMART (Mayo Stratification for Myeloma And Risk-adapted Therapy) is a consensus opinion that takes into account genetically determined risk status and the various treatment strategies currently available.
• Risk stratification and individualizing treatment options is complex and based not just on the cytogenetic classification presented here, but also on various host factors, disease stage, and a variety of other prognostic factors
• Therefore we recommend all patients with newly diagnosed myeloma be seen at least once at a referral center with expertise in the disease
Her er deres forslag til behandlingsflowchart, revideret 2014