Myeloma: diagnosis and management

Diagnostic investigations to predict treatment outcomes:- What is the prognostic value of the Hevylite assay and ratio compared with other prognostic factors and tests, including the serum-free light-chain assay and fluorescence in-situ hybridisation (FISH), in people with newly diagnosed myeloma who are starting treatment?

Imaging investigations for newly diagnosed myeloma:- What is the comparative effectiveness of whole-body MRI, fluorodeoxyglucose positron emission tomography CT (FDG PET-CT) and whole-body low-dose CT in detecting lesions that may determine the start of treatment for people with newly diagnosed myeloma?

Management of smouldering myeloma:- Which combinations of FISH, molecular technologies, bone marrow plasma cell percentage, whole-body imaging, immunophenotype, serum-free light-chain levels or ratio, Hevylite, paraprotein levels, immunoparesis, and International Staging System (ISS) are most effective at risk stratification for people with smouldering myeloma? What is the comparative effectiveness of fixed duration treatment (with or without bone-directed therapy), continuous treatment (with or without bone-directed therapy) and no treatment (with or without bone-directed therapy) for people with smouldering myeloma?

Allogeneic stem cell transplantation:- What is the effectiveness of combined autologous–allogeneic stem cell transplantation compared with autologous stem cell transplantation, plus consolidation and maintenance treatment in chemosensitive patients at first response or first relapse?

Bisphosphonates for the prevention of bone disease:- What is the effectiveness of monthly zoledronic acid given indefinitely compared with zoledronic acid given for a fixed duration in patients with myeloma?