Veidlapa Nr. M-3 (8)

Study Course Description

Oncohaematological Diseases of Plasma Cells

Main Study Course Information

Course Code

RHE_059

Branch of Science

Clinical medicine

ECTS

7.00

Target Audience

Medicine

LQF

Level 8

Study Course Implementer

Course Supervisor

Sandra Lejniece

Residency Speciality

Speciality

Hematologist

Supervisor of Medical Speciality

Sandra Lejniece

Contacts

About Study Course

Objective

To ensure acquisition and improvement of theoretical knowledge and practical skills in oncohaematological diseases of plasma cells in accordance with the requirements of the haematology specialty in order to prepare the doctor for certification in the haematology specialty.

Learning Outcomes

Knowledge

1.- Will know about myeloma; - Will know about monoclonal gammopathy of undetermined significance and solitary plasmacytoma, monoclonal immunoglobulin deposition disease (amyloidosis); - Will know about Waldenström macroglobulinemia.

Skills

1.- Will be able to diagnose and treat patients with oncohaematological diseases of plasma cells.

Competences

1.Diagnosis and treatment of patients with oncohaematological diseases of plasma cells.

Assessment

Individual work

Title	% from total grade	Grade
1. Individual work	-	-
1. Independently studies the literature related to the course topics; 2. Independently prepares for seminars; 3. Independently collects disease anamnesis data, objectively examines the patient, formulates a preliminary diagnosis, which is discussed with the lecturer; 4. Gets acquainted with and analyses medical documentation; 5. Completes medical documentation; 6. Independently follows the instructions of the certified specialist.

Examination

Title	% from total grade	Grade
1. Examination	-	-
Mandatory attendance of seminars (100%) and performance of practical work (100%) in each study course.

Study Course Theme Plan

FULL-TIME

Part 1

Seminar

Modality	Location
-	-

Topics

Myeloma - causes, pathogenesis, clinical picture, laboratory changes, complications, staging, treatment, prognosis.

Seminar

Modality	Location
-	-

Topics

Monoclonal gammopathy of undetermined significance. Solitary plasmacytoma. Monoclonal immunoglobulin deposition disease (amyloidosis).

Seminar

Modality	Location
-	-

Topics

Waldenström macroglobulinemia, pathogenesis, clinical picture, treatment.

Total ECTS (Creditpoints):

7.00

Number of Residency Seminars:

Length (weeks):

Final Examination:

Residency exam (Theory and practice)

Bibliography

Required Reading

Rajkumar SV, Dimopoulos MA, Palumbo A, Blade J et al. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol. 2014; 15(12):e538-48

Palumbo A; Avet-Loiseau H; Oliva S; Lokhorst HM et al.Revised International Staging System for Multiple Myeloma: A Report From International Myeloma Working Group. J Clin Oncol. 2015; 33(26):2863-9

Arber DA, Orazi A, Hasserjian R, et al. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood 2016; 127:2391-2405.

Mikulasova A, Wardell CP, Murison A et al .: The spectrum of somatic mutations in monoclonal gammopathy of undetermined significance indicates a less complex genomic landscape than that in multiple myeloma. Haematologica 102: 1617-1625, 2017. DOI: 10.3324 / haematol.2017.163766

Bergsagel PL, Chesi MV Molecular classification and risk stratification of myeloma. Hematol Oncol 31 Suppl 1: 38-41, 2013. DOI: 10.1002 / hon. 2065

Additional Reading

Rajkumar SV: Updated Diagnostic Criteria and Staging System for Multiple Myeloma. Am Sco Clin Oncol Educ Book 35: e418-e423, 2016. DOI: 10.1200 / EDBK _159009

Kortüm KM, Mai EK, Hanafiah NH et al .: Targeted sequencing of refractory myeloma reveals a high incidence of mutations in CRBN and Ras pathway genes. Blood 128: 1226-1233, 2016. DOI: 10.1182 / blood-2016-02-698092

Mitchell JS, Li N, Weinholf N et al .: Genome-wide association study identifies multiple susceptibility loci for multiple myeloma. Nat Commun 7: 2050, 2016. DOI: 10.1038 / ncomms12050

Landgren O, Linet MS, McMaster ML et .: Familial characteristics of autoimmune and hematologic disorders in 8,406 multiple myeloma patients: A population-based case-control study. International Journal of Cancer 118: 3095-3098, 2006. DOI: 10.1002 / ijc.21745

Wallin A, Larsson SC: Body mass index and risk of multiple myeloma: A meta-analysis of prospective studies. Eur J Cancer 47: 1606-1615, 2011. DOI: 10.1016 / j.ejca.2011.01.020

Weiss BM, Abadie J, Verma P et al .: A monoclonal gammopathy precedes multiple myeloma in most patients. Blood 113: 5418-5422, 2009. DOI: 10.1182 / blood-2008-12-195008

Landgren O, Kyle RA, Pfeiffer RM et al .: Monoclonal gammopathy of undetermined significance (MGUS) consistently precedes multiple myeloma: A prospective study. Blood 113: 5412-5417, 2009. DOI: 10.1182 / blood-2008-12-194241

Eisele L, Dürig J, Hüttmann A et al .: Prevalence and progression of monoclonal gammopathy of undetermined significance and light-chain MGUS in Germany. Annals of Hematology 91: 243-248, 2012. DOI: 10.1007 / s00277-011-1293-1

Zingone A, Kuehl WM: Pathogenesis of monoclonal gammopathy of undetermined significance and progression to multiple myeloma. Seminars in Hematology 48: 4-12, 2011. DOI: 10.1053 / j.seminhematol.2010.11.003

10.

Dispenzieri A, Katzmann JA, Kyle RA et al .: Prevalence and risk of progression of light-chain monoclonal gammopathy of undetermined significance: a retrospective population-based cohort study. Lancet 375: 1721-1728, 2010. DOI: 10.1016 / S0140-6736 (10) 60482-5

11.

Kristinsson SY, Björkholm M, Andersson TM et al .: Patterns of survival and causes of death following a diagnosis of monoclonal gammopathy of undetermined signficance: a population-based study. Haematologica 94: 1714-1720, 2009. DOI: 10.3324 / haematol.2009.010066

12.

Ludwig H, Hajek R, Tothova E et al .: Thalidomide-dexamethasone compared with melphalan-prednisolone in elderly patients with multiple myeloma. Blood 113: 3435-3442, 2009. DOI: 10.1182 / blood-2008-07-169565

13.

Dimopoulos MA, Cheung MC, Roussel M, et al .: Impact of renal impairment on outcomes with lenalidomide and dexamethasone treatment in the FIRST trial, a randomized, open-label phase 3 trial in transplant-ineligible patients with multiple myeloma. Haematologica 101: 363-370, 2016. DOI: 10.3324 / haematol.2015.133629

14.

Dimopoulos MA, Roussou M, Gavriatopoulou M et al .: Bortezomib-based triplets are associated with a high probability of dialysis independence and rapid renal recovery in newly diagnosed myeloma patients with severe renal failure or those requiring dialysis. Am J Hematol 91: 499-502, 2016. DOI: 10.1002 / ajh.24335

15.

Dimopoulos MA, Sonneveld P, Leung N et al .: International Myeloma Working Group Recommendations for the Diagnosis and Management of Myeloma-Related Renal Impairment. J Clin Oncol 34: 1544-1557, 2016. DOI: 10.1200 / JCO.2015.65.0044

16.

St Bernard R, Chodirker L, Masih-Khan E, Jiang H, Franke N, Kukreti V, Tiedemann R, Trudel S, Reece D, Chen CI. Efficacy, toxicity and mortality of autologous SCT in multiple myeloma patients with dialysis-dependent renal failure. Bone Marrow Transplant 50: 95-99, 2015. DOI: 10.1038 / bmt.2014.226

17.

Zannetti BA, Zamagni E, Santostefano M et al .: Bortezomib-based therapy combined with high cut-off hemodialysis is highly effective in newly diagnosed multiple myeloma patients with severe renal impairment. Am J Hematol 90: 647-652, 2015. DOI: 10.1002 / ajh.24035

18.

Bridoux F, Carron PL. Pegourie B et al .: Effect of high-cutoff hemodialysis vs conventional hemodialysis on hemodialysis independence among patients with myeloma cast nephropathy: a randomized clinical trial. JAMA 318: 2099-2110, 2017. DOI: 10.1001 / jama.2017.17924

19.

Lokhorst HM, van der Holt B, Cornelissen JJ et al .: Reduced relapse rate in upfront tandem autologous / reduced-intensity allogeneic transplantation in multiple myeloma only results in borderline non-significant prolongation of progression-free but not overall survival. Haematologica 100: e508-510, 2015. DOI: 10.3324 / haematol.2015.128728

20.

Richardson PG, Hungria VT, Yoon SS et al .: Panobinostat plus bortezomib and dexamethasone in relapsed / relapsed and refractory myeloma: outcomes by prior treatment. Blood Dec 2 Epub ahead of print. DOI: 10.1182 / blood-2015-09-665018

21.

San Miguel J, Weisel K, Moreau P et al .: Pomalidomide plus low-dose dexamethasone versus high-dose dexamethasone alone for patients with relapsed and refractory multiple myeloma (MM-003): a randomized, open-label, phase 3 trial. Lancet Oncol 14: 1055-1066, 2013. DOI: 10.1016 / S1470-2045 (13) 70380-2

22.

Palumbo A, Chanan-Khan A, Weisel K et al .: Daratumumab, Bortezomib, and Dexamethasone for Multiple Myeloma. N Engl J Med 375: 754-766, 2016. DOI: 10.1056 / NEJMoa1606038

23.

Dimopoulos M, Oriol H, Nahi H et al .: Daratumumab, Lenalidomide, and Dexamethasone for Multiple Myeloma. N Engl J Med 375: 1319-1331, 2016. DOI: 10.1056 / NEJMoa1607751

24.

Lonial S, Dimopoulos MA, Palumbo A et al .: Elotuzumab Therapy for Relapsed or Refractory Multiple Myeloma. N Engl J Med 373: 621-631, 2015. DOI: 10.1056 / NEJMoa1505654

Other Information Sources

NCCN Clinical Practice Guidelines in Oncology: Multiple Myeloma. Available from: http:// www.nccn.org/professionals/physicians_gls/pdf/myelomapdf. Version 2.2020-October 9, 2019.