Dear Lisa
Thank you for posting on the Myeloma UK Discussion Forum. I am sorry that you haven’t had any replies to date. My name is Ellen and I am one of the Myeloma Information Specialists here at Myeloma UK.
Thank you for taking the time to outline the background information in your case – that is helpful.
Unfortunately as you may know at the moment no definitive test yet exists that shows which patients diagnosed with MGUS will progress to myeloma and who will remain stable long-term. As you know the majority of MGUS patients do not go on to develop myeloma and as yet the cause of progression from MGUS to myeloma is not fully understood but as you correctly state probably involves changes at genetic level – research into this is ongoing. In the absence of any symptoms a GP would not be minded to refer all patients to a haematologist or to order genetic testing (florescence in-situ hybridisation – FISH test), as in most instances this would not alter management of the situation. As you may be aware FISH testing provides a ‘snapshot’ of the blood at that moment in time and we now know that genetic profiles can change from test to test.
As a result guidelines outlined by The British Committee for Standards in Haematology (BCSH) do not currently recommend testing of MGUS patients.
In contrast NICE guidelines for the diagnosis and management of myeloma patients (2016) do recommend FISH testing is undertaken on the bone marrow biopsy sample in order to provide prognostic information. Whilst this information – gathered within clinical trials – is contributing to the development of individualised treatment for myeloma patients, research in this area is also still ongoing and we are not yet in a position to stratify treatment for individuals.
I will feedback your comments to my colleagues here at Myeloma UK and within the wider myeloma community when the opportunity arises. If you would like to discuss this further please do get back in touch via email to askthenurse@myeloma.org.uk or alternatively you can call the Myeloma Infoline on 0800 980 3332, Debbie, Jude or I will do our best to answer any questions you may have.
With best wishes
Ellen
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This reply was modified 7 years, 5 months ago by ellen.