The 20 2 20 rule for myeloma is a Mayo Clinic risk stratification model used for smoldering multiple myeloma and is used to identify patients that are at high risk of progressing to active myeloma within 2 years.
The 20 2 20 rule for myeloma defines a person with smoldering multiple myeloma as high risk as having 2 or more of :> 20% plasma cells in their bone marrow, M-protein >2 g/dL, and a serum free light chain (FLC) ratio > 20.
The key components and clinical significance of the 20 2 20 rule for myeloma includes.
The definition is that > 20% of clonal bone marrow plasma cells, serum M-protein > 2 g/dL which is often noted as 20 g/L in some literature, and involved/uninvolved FLC ratio > 20.
The risk prediction of the 20 2 20 rule for myeloma is patients that meet 2 or more of these criteria have approximately a 47% to 80% chance of progressing to active myeloma within 2 years.
The 20 2 20 rule for myeloma model was also validated by the International Myeloma Foundation and is also considered a standard tool for assessing smoldering multiple myeloma.
And the 20 2 20 rule for myeloma is also often used alongside of genetic testing for more precise and personalized risk scoring.
The purpose of the 20 2 20 rule for myeloma is for helping clinicians to identify high risk patients who may benefit from early intervention or closer monitoring rather than a watch and wait approach for the smoldering multiple myeloma.
Multiple myeloma cancer is a cancer of the bone marrow plasma cells, which cause abnormal protein buildup of M protein, which results in bone lesions, kidney damage, anemia and immune system suppression.
Multiple myeloma cancer is considered to be incurable, although multiple myeloma is also highly treatable, especially when caught early.
New therapies for multiple myeloma improve your prognosis significantly and allow you to live active lives.
Common symptoms of multiple myeloma are bone pain, especially in the back or the ribs, fatigue, frequent infections and high calcium levels.
The exact cause of multiple myeloma is not know, although multiple myeloma also involves genetic mutations in the plasma cells, which cause them to grow uncontrollably.
Risk factors for multiple myeloma include being male, being over age 65, being of African American heritage, being obese and having a family history of multiple myeloma.
Multiple myeloma often develops from a precursor condition that is called monoclonal gammopathy of undetermined significance.
Multiple myeloma is often diagnosed through blood and urine tests to check for M protein, along with bone marrow biopsies and imaging tests like MRI, CT and PET scans to assess for bone damage.
The treatment for multiple myeloma often involves a combination of targeted therapies, immunomodulatory agents like lenalidomide, proteasome inhibitors like bortezomib, steroids and also autologous stem cell transplants.