Current RMA Instruments
| Reasonable Hypothesis SOP | 95 of 2021 |
| Balance of Probabilities SOP | 96 of 2021 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 203.0-203.1,238.6
- ICD-10-AM Codes: C90
Brief description
Myeloma is a cancer of plasma cells arising in the bone marrow. Plasma cells are a type of white blood cell.
Confirming the diagnosis
Diagnosis is complex and requires specialist opinion based on a range of tests including bone marrow biopsy and serum electrophoresis and immunofixation.
The relevant medical specialist is a haematologist or haematologist oncologist.
Additional diagnoses covered by SOP
- Multiple myeloma
- Multiple myelomatosis
- Plasma cell leukaemia
- Solitary myeloma
- Solitary plasmacytoma (of bone or extramedullary site)
Conditions not covered by SOP
- Acute myeloid leukaemia*
- Chronic myeloid leukaemia*
- Monoclonal gammopathy of undetermined significance - declared not a disease by the RMA
- Non-Hodgkin lymphoma*
* another SOP applies
Clinical onset
The clinical presentation is variable. The condition may be asymptomatic and uncovered by routine blood testing or X-rays. Bone pain is a common presenting symptom. Clinical onset is likely to be when test results first indicate abnormalities that are subsequently confirmed to be due to myeloma, are present. It may be possible to back date onset to an earlier time based on the presenting symptoms.
Clinical worsening
The only SOP worsening factor is for inability to obtain appropriate clinical management. Treament may be initially effective and may prolong survival. The usual course of myeloma is of relapse following treatment.