Vincent Rajkumar, MD

Our comprehensive Review on MGUS: Monoclonal Gammopathy of Undetermined Significance @NEJM

5% of people over age 50 have MGUS. Every physician needs to know and understand MGUS. Lots of Tables and Figures. www.nejm.org/doi/abs/10.1...

So excited to see this thread on BlueSky, @vincentrk.bsky.social! Thank you as always for your excellent summaries!

Wow. I’m overwhelmed by the response here. Will post more on here.

It is through clinical trials that new treatments are discovered, tested, and approved.

A medicine is a chemical and will stay so in the absence of clinical trials.

No trial, no medicines.
I’m thankful for colleagues who run clinical trials.
#ASH24

9. All the active drugs for myeloma in one simple table. Black font = approved drugs; blue font = investigational.

8. Will post hot-of-the-press smoldering myeloma SMM treatment algorithm Monday afternoon #ASH24

AQUILA trial!
Stay tuned.

Multiple myeloma: 2024 update on diagnosis, risk‐stratification, and management Disease overview Multiple myeloma accounts for approximately 10% of hematologic malignancies. Diagnosis The diagnosis requires ≥10% clonal bone marrow plasma cells or a biopsy proven plasmacytoma ...

7. For more details check out my 2024 Annual myeloma diagnosis and treatment update published in Am J Hematology. #OpenAccess
#ASH24 onlinelibrary.wiley.com/doi/10.1002/...

mSMART

6. In general if possible and available a clinical trial is preferable to these algorithms.

These are general principles. You have to individualize treatment selection. Also treatments evolve. Follow msmart.org for updates
@MayoMyeloma #ASH24

5. True Penta-Refractory myeloma (refractory to PI, Imid, CD38, alkylator, and BCMA targeted approach).
msmart.org #ASH24

4. Second or later relapse
mSMART.org #ASH24

3) First Relapse

I don’t recommend CART in first relapse even though it’s approved except in very selected patients (eg., high risk progressing early while on quad).

msmart.org #ASH24

2. Newly diagnosed transplant eligible. Quadruplet induction.

See below for transplant timing and maintenance. #ASH24

My Annual Updated Myeloma Treatment Algorithms thread. Bookmark! #ASH24
#ASH24VR

1. Newly diagnosed transplant ineligible. Quadruplet unless frail. Maintenance varies by risk stratification.

My first post here.

Holy cow! And I already have followers here! Thanks so much everyone.

I’m still trying to figure out how to post on X and here.
#ASH24