Do you change treatment for confirmed biochemical progression in patients with otherwise secretory MM even if the M-spike is <0.5 g/dL?  

I agree- these decisions should be individualized. However, the reason I posted this comment is to draw attention to the problem which hematologists and oncologists have all but ignored - a huge problem with overtreatment. 30%+ what we do is unnecessary and quite likely harmful. We are not short on ...

I don’t necessarily think of one type of bio chemical progression differently than any other, whether it is light chains or M spike. What is more important to me is the pace of increase. Somebody who has a jump of 10 mg/dL in their difference in free light chains over six months is very differ...

Since technically, the minimum absolute M-spike increase needed to define PD is 0.5 g/dL, I assume this refers to a scenario where the difference in free light chains (dFLC) meets criteria for PD (e.g., ≥100 mg/L rise and ≥25% rise) but the patient has a history of a measurable M-protein and t...