16
Disclaimer
is pocket guide is derived om recommendations in the American Society of Clinical Oncolog y Guideline.
is resource is a practice tool based on ASCO
®
practice guidelines and is not intended to substitute for
the independent professional judgment of the treating physician. Practice guidelines do not account for
individual variation among patients. is pocket guide does not purport to suggest any particular course of
medical treatment. Use of the practice guidelines and this resource are voluntary. e practice guidelines
and additional information are available at www.asco.org/hematologic-malignancies-guidelines. Copyright
©2019 by American Society of Clinical Oncolog y. All rights reserved.
Source
Mikhael J, Ismaila N, Cheung MC, Costello C, Dhodapkar MV, Kumar S, Lacy M, Lipe B, Little RF,
Nikonova A, Omel J, Peswani N, Prica A, Raje N, Seth R, Vesole DH, Walker I, Whitley A, Wildes
TM, Wong SWK, Martin T. Treatment of Multiple Myeloma: ASCO and CCO Joint Clinical Practice
Guideline. 10.1200/JCO.18.02096
106 Commerce Street, Suite 105
Lake Mary, FL 32746
TEL: 407.878.7606 • FAX: 407.878.7611
Order additional copies at GuidelineCentral.com
Copyright © 2019 All rights reserved
ASCOMUL1932b
ASCO believes that cancer clinical trials are vital to inform medical decisions and
improve cancer care and that all patients should have the opportunity to participate.
Additional information, which may include data supplements, slide sets, and other clinical
tools and resources, is available at www.asco.org/hematologic-malignancies-guidelines.
Abbreviations
ADLs, activities of daily living ; ASCO, American Society of Clinical Oncology; BMI, body mass
index; C, carfilzomib; CRAB, hypercalcemia, renal insufficiency, anemia, and bone lesions; CT,
computed tomography; Cy, cyclophosphamide; D, dexamethasone; D-KRd, daratumumab, carfilzomib,
lenalidomide, dexamethasone; DRd, daratumumab, lenalidomide and dexamethasone; D-VRd,
daratumumab, bortezomib, lenalidomide, dexamethasone; eGFR, estimated glomerular filtration rate;
FDG-PET/CT, positron emission tomography-computed tomography; FISH, fluorescence in situ
hybridization; FLC, free light chain; IADLs, instrumental activities of daily living ; IMWG, International
Myeloma Working Group; ISS, International Staging System; KPS, Karnofsky Performance Status KRd,
carfilzomib, lenalidomide and dexamethasone; M, melphalan; MMS, Mini Mental Status Exam; MNA-
SF, Mini Nutritional Assessment-Short Form; MRD, minimal residual disease; MRI, magnetic resonance
imaging ; OS, overall survival; P, prednisone; PFS, progression-free survival; pts, points; R, lenalidomide;
SCT, stem cell transplant; SPMSQ, Short Portable Mental Status Questionnaire; T, thalidomide; V,
Bortezomib; VCd, bortezomib, cyclophosphamide,and dexamethasone; VRd, bortezomib, lenalidomide
and dexamethasone
Recommendation Grading
Type Benefit/harm Evidence Quality
Strength of
Recommendation
EB Evidence-
based
B Benefits
outweigh harms
H High Strong
FC
Formal
consensus
H Harms outweigh
benefits
I Intermediate Moderate
IC Informal
consensus
B/H Relative balance
of benefits and
harms
L Low Weak
Ins Insufficient
