NCCN Guidelines for Patients® | Multiple Myeloma

47 NCCN Guidelines for Patients ® : Multiple Myeloma, 2019 4 Treatment guide Active (symptomatic) multiple myeloma Guide 6 shows the next treatment options after primary treatment. Follow-up tests are used to check how well primary treatment is working. An outcome or improvement caused by treatment is called a treatment response . Your next treatment options are based on results of the follow-up tests. Test results and next treatment options The next treatment options are based on how the myeloma responded to primary treatment. Guide 6. Next treatment options and follow-up tests Test results Next treatment options Next steps Treatment response ª • Autologous stem cell transplant • Allogeneic stem cell transplant • Stay on myeloma therapy (until best response) or maintenance therapy ª Follow-up tests • CBC with differential and platelet count • Blood chemistry tests: creatinine and corrected calcium • Serum quantitative immunoglobulins, SPEP, and SIFE • 24-hour urine for total protein, UPEP, and UIFE • Serum FLC assay as needed • Bone survey or whole-body low-dose CT scan as needed • Bone marrow aspirate and biopsy as needed • Whole-body or skeletal MRI or whole-body FDG PET/CT scan as needed • Assess for MRD ( m inimal r esidual d isease) as needed No treatment response ª Treatment for relapse or progressive disease: • Therapy for previously treated myeloma (see list on page 49) • Clinical trial • Autologous stem cell transplant • Allogeneic stem cell transplant ª Palliative care