Routinediagnostik

Beachte: Abklärung MGUS

Blutuntersuchungen

        • Myelom Block
          • Diagnose
          • Zyklustag 1
          • Responsebeurteilung
        • Routine Block
          • 1x/ Woche unter Therapie

Harnuntersuchungen

        • 24h Sammelurin
          • Diagnose
          • Responsebeurteilung
        • Spontanharn
          • Zyklustag 1

Knochenmarkbiopsie

        • Diagnose
        • Responsebeuteilung

Zytogenetik

        • Diagnose

FISH

        • Diagnose

Skelettröntgen

        • Diagnose
        • Responsebeurteilung
        • Symptomatik

MR - Wirbelsäule,Becken

        • Diagnose
        • Symptomatik

Nervenleitgeschwindigkeit

        • Diagnose bei Verdacht
        • Symptomatik unter Therapie

Zusammenfassung

        • FlowChart

Literatur

 

optionale Diagnostik

PET/CT

        • Unterscheidung SMM-MGUS

low dose CT

        • empfohlen statt SK_Rö
        • Diagnose
        • Responsebeurteilung
        • Symptomatik

PET-CT:

Diagnose

  • useful in patients with elevated lactate dehydrogenase, Bence Jones protein escape, and otherwise rapidly recurrent disease or with suspected extramedullary plasmacytoma.
  • helpful for detection of extraosseous soft tissue masses and evaluation of rib and appendicular bone lesions
  • PET-CT obviates the need for a skeletal survey

 

Prognose

  • persistence of 18Ffluorodeoxyglucose (FDG) uptake 3 months after ASCT had significantly worse progression- free survival (PFS) and overall survival (OS).
  • The prognostic impact of this parameter was stronger than that of cytogenetic abnormalities.
  • persistent focal lesions on PET-CT in MM after high-dose therapy may indicate the presence of residual clonal cells, which increases the risk of relapse. This could impact our future therapeutic strategies, leading to the systematic administration of consolidation therapy in this high-risk group of patients