Screening for myeloma/MGUS. Thread #medtwitter
1/ General screening of asymptomatic persons is not recommended. iStopMM is a randomized trial to determine role of screening, and also the role of more close follow up to enable early detection clinicaltrials.gov/ct2/show/NCT03… @IMFmyeloma
1/ General screening of asymptomatic persons is not recommended. iStopMM is a randomized trial to determine role of screening, and also the role of more close follow up to enable early detection clinicaltrials.gov/ct2/show/NCT03… @IMFmyeloma
2/ I now recommend screening to detect high risk smoldering myeloma in persons with 2 or more first degree relatives with myeloma, & in blacks with one or more affected relative. One time screening at age 50-60, or 10 yrs before age of diagnosis of myeloma in relative @neuherman
3/ Whenever we want to look for myeloma / AL amyloidosis due to clinical suspicion, or to screen high risk individuals, the tests to do are: serum protein electrophoresis, serum immunofixation, & serum free light chain assay. @MayoMyeloma @MayoProceedings mayoclinicproceedings.org/article/S0025-…
4/ These tests will only show presence or absence of M protein. They don’t diagnose disease per se. By far, The most common reason for presence of M protein is MGUS. MGUS does not need treatment. ashpublications.org/blood/article-… @MayoClinic @BloodJournal 
There are many other diseases to consider if clinically appropriate, when a monoclonal protein is detected. These disorders should be diagnosed based on strict criteria. #myelomaVR @TheLancetOncol thelancet.com/journals/lanon…
@sykristinsson I tagged you in the first tweet of this thread. And I think it got deleted inadvertently when I copy pasted the trial link. Sorry! This is your landmark study. Visionary.
