title: Management of newly diagnosed symptomatic multiple myeloma: updated Mayo Stratification of Myeloma and Risk-Adapted Therapy (mSMART) consensus guidelines 2013.
abstract: Multiple myeloma remains an incurable neoplasm of plasma cells that affects more than 20,000 people annually in the United States. There has been a veritable revolution in this disease during the past decade, with dramatic improvements in our understanding of its pathogenesis, the development of several novel agents, and a concomitant doubling in overall survival. Because multiple myeloma is a complex and wide-ranging disorder, its management must be guided by disease- and patient-related factors; emerging as one of the most influential factors is risk stratification, primarily based on cytogenetic features. A risk-adapted approach provides optimal therapy to patients, ensuring intense therapy for aggressive disease and minimizing toxic effects, providing sufficient but less intense therapy for low-risk disease. This consensus statement reflects recommendations from more than 20 Mayo Clinic myeloma physicians, providing a practical approach for newly diagnosed patients with myeloma who are not enrolled in a clinical trial.
authors.affiliation: Division of Hematology/Oncology, Mayo Clinic, Scottsdale, AZ 85259, USA. Mikhael.joseph@mayo.edu
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Mikhael
authors.forename: David
authors.initials: D
authors.lastname: Dingli
authors.forename: Vivek
authors.initials: V
authors.lastname: Roy
authors.forename: Craig B
authors.initials: CB
authors.lastname: Reeder
authors.forename: Francis K
authors.initials: FK
authors.lastname: Buadi
authors.forename: Suzanne R
authors.initials: SR
authors.lastname: Hayman
authors.forename: Angela
authors.initials: A
authors.lastname: Dispenzieri
authors.forename: Rafael
authors.initials: R
authors.lastname: Fonseca
authors.forename: Taimur
authors.initials: T
authors.lastname: Sher
authors.forename: Robert A
authors.initials: RA
authors.lastname: Kyle
authors.forename: Yi
authors.initials: Y
authors.lastname: Lin
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Russell
authors.forename: Shaji
authors.initials: S
authors.lastname: Kumar
authors.forename: P Leif
authors.initials: PL
authors.lastname: Bergsagel
authors.forename: Steven R
authors.initials: SR
authors.lastname: Zeldenrust
authors.forename: Nelson
authors.initials: N
authors.lastname: Leung
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Drake
authors.forename: Prashant
authors.initials: P
authors.lastname: Kapoor
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Ansell
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Witzig
authors.forename: John A
authors.initials: JA
authors.lastname: Lust
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Dalton
authors.forename: Morie A
authors.initials: MA
authors.lastname: Gertz
authors.forename: A Keith
authors.initials: AK
authors.lastname: Stewart
authors.forename: Keith
authors.initials: K
authors.lastname: Stewart
authors.forename: S Vincent
authors.initials: SV
authors.lastname: Rajkumar
authors.forename: Asher
authors.initials: A
authors.lastname: Chanan-Khan
authors.forename: Martha Q
authors.initials: MQ
authors.lastname: Lacy
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005819:Genetic Markers; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D060828:Induction Chemotherapy; D060046:Maintenance Chemotherapy; D009101:Multiple Myeloma / Q000175:diagnosis / Q000235:genetics / Q000628:therapy*; D018570:Risk Assessment; D033581:Stem Cell Transplantation
chemical_list: D000970:Antineoplastic Agents; D005819:Genetic Markers; D007155:Immunologic Factors