Table 1 Clinical assessment, imaging, and laboratory studies included for participants in the different study arms of the iStopMM study as per protocol.

From: Iceland screens, treats, or prevents multiple myeloma (iStopMM): a population-based screening study for monoclonal gammopathy of undetermined significance and randomized controlled trial of follow-up strategies

Test

Arm 2–low risk and LC-MGUS

Arm 2–non-low risk

Arm 3–All

SMM and SWM

MM and WM

Physical exama

First visit

First visit

Each visit

Each visit

At diagnosis

Blood sampling

SPEP

FLC assay

Each visit

Each visit

Each visit

Each visit

At diagnosis

CBC

First visit

Each visit

Each visit

Each visit

At diagnosis

Total calcium

Albumin

Creatinine

First visit

First visit

Each visit

Each visit

At diagnosis

CRP

LDH

ß2M

Each visit

Each visit

At diagnosis

TnT

pro-BNP

Annually

Annually

At diagnosis

Bone marrow

Smear

Biopsy

As clinically indicated

0 months

Except if LC

0 and 60 months

Annually

At diagnosis

Urine

Protein dipstick

First visit

First visit

UPEP

If positive dipstick or if previously abnormal

If positive dipstick or if previously abnormal

Albumin/creatinine ratio

Annually

Annually

At diagnosis

ECG

Annually

Annually

At diagnosis

Imaging

     

WB-LDCT

0 and 60 months in LC- and non-IgM

Annually in LC- and non-IgM

At diagnosis of MM

Plain X-ray of bones

As clinically indicated

First visit in LC- and non-IgM

CT abdomen

First visit to IgM

0 and 60 months in IgM

Annually in IgM

At diagnosis of WM

MRI of bones

As clinically indicated

Follow-up

Every 2–3 years

Annual

Annual

Every 4–6 months

Single-visit

  1. Note that additional sampling and imaging were permitted as clinically indicated and decided at regularly scheduled clinical decision meetings.
  2. SMM smoldering multiple myeloma, SWM smoldering Waldenströms macroglobulinemia, MM multiple myeloma, WM Waldenströms macroglobulinemia, SPEP serum protein electrophoresis, FLC free light chains, CBC complete blood count, CRP C-reactive protein, LDH Lactate dehydrogenase, ß2M ß-2-microglobulin, TnT Troponin T, pro-BPN pro-Brain natriuretic peptide, UPEP Urine protein electrophoresis, ECG electrocardiogram, WB-LDCT whole-body low-dose computerized tomography, CT Computerized tomography, MRI magnetic resonance imaging, LC Light chain.