MM - BCOP Exam Questions with Correct Answers| Latest Update Guaranteed Success
Poor prognostic factors Del(13)
t(4;14)
Del 17p13 (poor survival)
trisomy 21 (decreased OS)
good prognosis t(11;14) - improved survival
trisomies 3 and 5
Gene expression profiling (GEP) Technology that extracts RNA from CD138 (+) plasma cells
obtained from BM aspirate; may provide addtnl prognostic value to further define risk. Useful
in determining aggressiveness of MM and tailor tx
CRAB symptoms Calcium (>11mg/dL)
Renal dysfunction (SCr>2mg/dL; CrCl<40)
Anemia (Hg <10 or >2 LLN)
Bone disease
International Staging System (ISS) Preferred staging system d/t ease of use and validated for
conventional chemo and HD chemo; only used in symptomatic pts
ISS stage I beta-2 microglobulin <3.5mg/L
albumin >/=3.5g/dL
ISS stage II neither stage I or III
ISS stage III beta-2 microglobulin >/=5.5mg/L
, Mayo Stratification for Myeloma and Risk-adapted Therapy (mSMART) Risk based on
cytogenetics
Translocations and deletions as detected by FISH
Updated to aid in prognosis and tx approach
mSMART high risk FISH: Del17p, t(14;16), t(14;20)
mSMART intermediate risk FISH: t(4;14), 1q gain
mSMART standard risk t(11;14), t(6;14)
Monoclonal gammopathy of undetermined significance (MGUS) median age - 72; probability
of progression to MM increases w/ increasing years; management: observation
Goal of therapy for MM Disease control
Improved QOL
Prolong survival
SOC for primary tx 3-drug regimen improves RR, depth of response, PFS and OS (doublet for
elderly or frail)
Induction tx Goal Reduce tumor burden prior to auto-HSCT
Agents to avoid in induction tx Alkylating agents and nitrosureas that are toxic to progenitor
cells (e.g., melphalan);
Prolonged exposure to lenalidomide (>3-6 cycles) before collecting stem cells
Poor prognostic factors Del(13)
t(4;14)
Del 17p13 (poor survival)
trisomy 21 (decreased OS)
good prognosis t(11;14) - improved survival
trisomies 3 and 5
Gene expression profiling (GEP) Technology that extracts RNA from CD138 (+) plasma cells
obtained from BM aspirate; may provide addtnl prognostic value to further define risk. Useful
in determining aggressiveness of MM and tailor tx
CRAB symptoms Calcium (>11mg/dL)
Renal dysfunction (SCr>2mg/dL; CrCl<40)
Anemia (Hg <10 or >2 LLN)
Bone disease
International Staging System (ISS) Preferred staging system d/t ease of use and validated for
conventional chemo and HD chemo; only used in symptomatic pts
ISS stage I beta-2 microglobulin <3.5mg/L
albumin >/=3.5g/dL
ISS stage II neither stage I or III
ISS stage III beta-2 microglobulin >/=5.5mg/L
, Mayo Stratification for Myeloma and Risk-adapted Therapy (mSMART) Risk based on
cytogenetics
Translocations and deletions as detected by FISH
Updated to aid in prognosis and tx approach
mSMART high risk FISH: Del17p, t(14;16), t(14;20)
mSMART intermediate risk FISH: t(4;14), 1q gain
mSMART standard risk t(11;14), t(6;14)
Monoclonal gammopathy of undetermined significance (MGUS) median age - 72; probability
of progression to MM increases w/ increasing years; management: observation
Goal of therapy for MM Disease control
Improved QOL
Prolong survival
SOC for primary tx 3-drug regimen improves RR, depth of response, PFS and OS (doublet for
elderly or frail)
Induction tx Goal Reduce tumor burden prior to auto-HSCT
Agents to avoid in induction tx Alkylating agents and nitrosureas that are toxic to progenitor
cells (e.g., melphalan);
Prolonged exposure to lenalidomide (>3-6 cycles) before collecting stem cells
