Introduction
Epidemiology
PULL-OUT SECTION
COMPLETE HOW TO TREAT QUIZZES ONLINE www. howtotreat. com. au
INSIDE Epidemiology Pathophysiology
Screening and clinical presentation
Diagnosis Treatment Case study
THE AUTHORS
DR JACINTA PERRAM haematology advanced trainee, Royal Prince Alfred and Concord Hospitals, Sydney.
DR CAROLINE DIX haematology advanced trainee, Royal Prince Alfred and Concord Hospitals, Sydney.
Multiple myeloma
Introduction
DR JOHN GIBSON head of department, Institute of Haematology, Royal Prince Alfred Hospital, Sydney.
WITH improving therapy options and life expectancy, patients receiving treatment for multiple myeloma are more likely than ever to be encountered by GPs. Recognising the common presenting symptoms, |
as well as when and how to screen for multiple myeloma, are important skills for all doctors.
In addition, the ability to identify common treatment side effects, and manage acute and chronic illnesses
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in the context of myeloma is becoming more important for the GP as increasing numbers of myeloma patients enter a stable, albeit temporary, chronic disease phase.
In this How to Treat, we will
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address the epidemiology, basic pathophysiology, presenting symptoms, screening and diagnostic criteria, staging and prognosis, and treatment options for multiple myeloma. |
Epidemiology
Copyright © 2017 Australian Doctor
MULTIPLE myeloma accounts for about 10 % of haematological malignancies, with around 1500 cases diagnosed in Australia annually. 1-3
The mean age at diagnosis is 70, limiting the intensity of potential treatments. However, cases do occur in younger individuals. 2, 3 Monoclonal gammopathy of uncertain significance is the premalignant disease and occurs at significantly higher rates than multiple myeloma, affecting around 4 % of people over 50, with progression to multiple myeloma occurring at a rate of about 1 % per year. 1
The life expectancy of patients with multiple myeloma has improved rapidly over the past two decades with the introduction of new therapeutic agents. Surveillance data from the National Cancer Institute in the US reveals a five-year survival rate of 29.7 % in 1990, increasing to 48.5 % in 2012. 4 Data from the Cancer Council of Australia indicate a five-year survival rate of 43 %. 5 cont’ d next page
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