Plasma cell dyscrasias and multiple myeloma
MGUS and its follow-up, smouldering myeloma and the 2/20/20 model, IMWG myeloma criteria, ISS and the 2025 IMS/IMWG high-risk definition, transplant-eligible VRd and transplant-ineligible DRd with Australian PBS access, cast nephropathy, VTE and infection prophylaxis, and relapse options.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Plasma cell disorders run from MGUS (common, benign, watched) through smouldering myeloma to multiple myeloma, defined by a myeloma-defining event.
- Median age at diagnosis is about 70. Myeloma is twice as common in people of African ancestry.
- Myeloma isn't curable, but quadruplet regimens, transplant and immunotherapy give many patients a decade or more.
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Sources
- MSAG clinical practice guidelines for newly diagnosed (transplant eligible and ineligible) and relapsed or refractory multiple myelomaAU/NZMedical Scientific Advisory Group to Myeloma Australia, 2026
- International Myeloma Working Group updated criteria for the diagnosis of multiple myelomaRajkumar SV et al., Lancet Oncol 2014;15:e538-48, 2014
- Hillengass J et al. International Myeloma Working Group consensus recommendations on imaging in monoclonal plasma cell disorders. Lancet Oncol 2019;20:e302-12International Myeloma Working Group, 2019
- International Myeloma Society/International Myeloma Working Group consensus recommendations on the definition of high-risk multiple myelomaAvet-Loiseau H et al., J Clin Oncol 2025;43:2739-51, 2025
- International Myeloma Working Group recommendations for the diagnosis and management of solitary plasmacytomasKastritis E et al., J Clin Oncol 2026;44:2447-59, 2026
- Treatment of Multiple Myeloma: ASCO Living GuidelineBanerjee R et al., J Clin Oncol 2026, 2026.1.3
- Daratumumab, bortezomib, lenalidomide and dexamethasone for multiple myeloma (PERSEUS)Sonneveld P et al., N Engl J Med 2024;390:301-13, 2024
- Daratumumab or active monitoring for high-risk smoldering multiple myeloma (AQUILA)Dimopoulos MA et al., N Engl J Med 2025;392:1777-88, 2025
- Schedule of Pharmaceutical Benefits, November 2026 (daratumumab, lenalidomide, bortezomib, carfilzomib, pomalidomide, elranatamab, selinexor)AU/NZAustralian Government Department of Health, Disability and Ageing, November 2026
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy