EHA-EMN Guidelines Integrate MRD and Mass Spectrometry Monitoring for Multiple Myeloma
These updated evidence-based guidelines from the European Hematology Association and European Myeloma Network incorporate the R2-ISS staging system and emerging prognostic tools including minimal residual disease assessment, circulating plasma cells, and mass spectrometry-based monoclonal protein monitoring. The guidelines cover 14 newly approved regimens including contemporary immunotherapies, and provide management algorithms for both newly diagnosed and relapsed/refractory disease. New guidance addresses cytokine release syndrome and immune effector cell-associated neurotoxicity.
The original study
EHA-EMN Evidence-Based Guidelines for diagnosis, treatment and follow-up of patients with multiple myeloma.
- Authors
- Dimopoulos MA, Terpos E, Boccadoro M, Moreau P, Mateos MV, Zweegman S, et al.
- Journal
- Nature reviews. Clinical oncology
- Type
- Journal Article, Review
- PMID
- 40624367
Original abstract
Since the publication in 2021 of the European Hematology Association (EHA) Clinical Practice Guidelines for the treatment of patients with smouldering multiple myeloma (SMM) and multiple myeloma (MM), developed in collaboration with the European Society for Medical Oncology, a novel international staging system (R2-ISS) has been developed, several prognostic factors are entering clinical practice (such as minimal residual disease, circulating plasma cells and monoclonal protein assessed by mass spectrometry) and, at the time of writing, 14 novel regimens have been approved by the EMA and/or the FDA for the treatment of patients with MM. A multidisciplinary group of experts from the EHA and European Myeloma Network, based in various institutions mostly located in Europe, have updated the previous guidelines and produced algorithms for everyday clinical practice that incorporate levels of evidence and grades of recommendation based on the aforementioned new data. In these Evidence-Based Guidelines, we provide key treatment recommendations for both patients with newly diagnosed MM and those with relapsed and/or refractory MM, including guidance for the use of established drugs as well as contemporary immunotherapies. Novel approaches for the management of patients with SMM focus on those who might require early intervention. Finally, we provide recommendations for myeloma-related complications and adverse events, such as bone disease, renal impairment and infections, as well as for those associated with T cell-mobilizing therapies, such as cytokine-release syndrome and immune effector cell-associated neurotoxicity syndrome.