BSH/UKMS Guidelines
Guidelines on the diagnosis, investigation and initial treatment of myeloma: a British Society for Haematology/UK Myeloma Forum Guideline.
Published on B-S-H website March 2021
Please find the link below to the most recent publication from NICE outlining Interim treatment change options during the COVID-19 pandemic issued on. It is endorsed by NHS England. Some of options proposed for multiple myeloma are:
- Allow oral pomalidomide with dexamethasone as second- or third-line therapy instead of intravenous treatments in patients previously treated with lenalidomide to reduce the need for chemotherapy and reduce admissions and risk of neutropenia.
- Allow first-line lenalidomide and dexamethasone for transplant eligible myeloma patients in preference to regimens that require more hospital attendances and parenteral administrations to reduce toxicity of treatment and number of admissions required for treatment.
- Allow second-line lenalidomide and dexamethasone for patients who have not been previously treated with bortezomib.
Please see link below to access the full document.
Interim treatment change options during the COVID-19 pandemic, endorsed by NHS England
UK Myeloma Forum guidance to support medical decision-making in the management of myeloma patients during the COVID-19 (Coronavirus) outbreak
It is clear that the current outbreak is going to impact the ability to deliver healthcare for some months to come. This is especially the case for systemic anti-cancer therapy.
To try and mitigate the impact of changing capacity, and to minimise the risk that the immunosppressive effects of myeloma therapy has, the guidance in the below document has been compiled on 25th March 2020 to help support myeloma doctors in their decision-making and treatment planning.
Position Statements
Dear Clinicians, MDT leads and Pharmacists,
In January 2021 NICE approved Lenalidomide maintenance for use in patients with multiple myeloma who have undergone stem cell transplantation as part of first line treatment.
This is a huge leap forward for care of myeloma patients in the UK. The specific recommendations are outlined in the Blueteq here. Contrary to previous STA’s on multiple myeloma, the start timing of this intervention is flexible and are left entirely to the clinician’s discretion depending on the individual patient situation:
Point 6 in the Blueteq form. The prescribing clinician understands that maintenance Lenalidomide is recommended to start at about day 100 after stem cell transplantation.
The protocol in the MRC MMXI trial on which this guidance is primarily based is worded in a very similar way and permitted flexibility of up to 9 months post transplantation before maintenance treatment was commenced.
We recommend that local MDTs adopt a flexible approach and make an individualised clinical decision with respect to the timing of commencing Lenalidomide maintenance treatment for this patient group. This will give the maximum number of patients the greatest possible benefit from this intervention.
Kind regards
Dr John Ashcroft
UKMF Chair
Guidelines on the diagnosis, investigation and initial treatment of myeloma: a British Society for Haematology/UK Myeloma Forum Guideline.
Published on B-S-H website March 2021
Please find the link below to the most recent publication from NICE outlining Interim treatment change options during the COVID-19 pandemic issued on. It is endorsed by NHS England. Some of options proposed for multiple myeloma are:
- Allow oral pomalidomide with dexamethasone as second- or third-line therapy instead of intravenous treatments in patients previously treated with lenalidomide to reduce the need for chemotherapy and reduce admissions and risk of neutropenia.
- Allow first-line lenalidomide and dexamethasone for transplant eligible myeloma patients in preference to regimens that require more hospital attendances and parenteral administrations to reduce toxicity of treatment and number of admissions required for treatment.
- Allow second-line lenalidomide and dexamethasone for patients who have not been previously treated with bortezomib.
Please see link below to access the full document.
Interim treatment change options during the COVID-19 pandemic, endorsed by NHS England
UK Myeloma Forum guidance to support medical decision-making in the management of myeloma patients during the COVID-19 (Coronavirus) outbreak
It is clear that the current outbreak is going to impact the ability to deliver healthcare for some months to come. This is especially the case for systemic anti-cancer therapy.
To try and mitigate the impact of changing capacity, and to minimise the risk that the immunosppressive effects of myeloma therapy has, the guidance in the below document has been compiled on 25th March 2020 to help support myeloma doctors in their decision-making and treatment planning.
Find out more
Annual Report
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Position Statement
Find out more about our Position Statements by clicking here.