Objectives
  • To be able to perform specialist assessment, treatment and counselling of patients with plasma cell dyscrasias

Awareness
  • Awareness of the existence of different biological and pathological types of plasma cell dyscrasias: monoclonal gammopathy of unknown significance, Waldenstr√∂m's, macroglobulinaemia, plasmacytoma, multiple myeloma, POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal protein, skin changes) and plasma cell leukaemia

  • Recognition of diagnostic procedures

  • Awareness of the existence of different prognostic factors

  • Appreciation of the availability of different drugs and treatments

  • Awareness of the indications for treatment in each instance

  • Appreciation of the management of treatment-related side effects

Knowledge
  • Familiarity with the different types of plasma cell dyscrasias and with the selection of the most appropriate treatment

  • Familiarity with the diagnostic tools available

  • Familiarity with the risk assessment work-up of prognostic factors

  • Familiarity with the indications and the value of radiation therapy, chemotherapy, autologous and allogeneic transplantation, monoclonal antibodies, targeted drugs and supportive and palliative care, but also with their limitations

  • Understanding of the strengths of treatment personalisation opportunities and the importance of offering individualised targeted therapies based on risk stratification, thus considering fluorescence in situ hybridisation (FISH) abnormalities, International Staging System (ISS), age, geriatric assessment etc

  • Understanding of the complications that derived from disease progression and those that are treatment-associated in the context of being familiar with supportive and palliative care strategies

Skills
  • Ability to contribute actively to a variety of clinical scenarios and patient presentations

  • Ability to discuss critically the treatment options and recommendations

  • Ability to perform a history and physical examination in patients with plasma cell dyscrasias, including different subtypes

  • Ability to contribute to discussions on general management strategies in order to understand all the considerations on which treatment to use and which sequence to select for the multidisciplinary strategy

  • Ability to prescribe various chemotherapeutic agents, immunotherapeutic and targeted agents and their potential interactions with radiation therapy where appropriate

  • Ability to understand conditions (such as performance status, patient clinical condition, concomitant disease(s), previous treatments, geriatric score etc) that are important for considering when to start and to stop treatment or to switch to another option

  • Ability to determine therapy according to the patient's characteristics, prognosis and medical history

  • Ability to manage side effects of various agents

  • Ability to discuss strategies with patients