Multiple myeloma diagnostic criteria: Difference between revisions
(/* Criteria for the Diagnosis of Smouldering Multiple MyelomaRajkumar, S. Vincent, Meletios A. Dimopoulos, Antonio Palumbo, Joan Blade, Giampaolo Merlini, María-Victoria Mateos, Shaji Kumar et al. "International Myeloma Working Group updated criteria...) |
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==Diagnostic Criteria== | ==Diagnostic Criteria== | ||
In November 2014, the International Myeloma Working Group (IMWG) updated the criteria for the diagnosis of multiple myeloma to include novel validated biomarkers that are associated with the development of CRAB features ([[hypercalcaemia]], [[renal failure]], [[anaemia]], and [[bone]] lesions). The update also clarified the underlying laboratory and radiographic findings of CRAB features as well as the histological and monoclonal protein requirements for the disease diagnosis.<ref name=lancet>Rajkumar, S. Vincent, Meletios A. Dimopoulos, Antonio Palumbo, Joan Blade, Giampaolo Merlini, María-Victoria Mateos, Shaji Kumar et al. "International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma." The Lancet Oncology 15, no. 12 (2014): e538-e548</ref> | In November 2014, the International Myeloma Working Group (IMWG) updated the criteria for the diagnosis of multiple myeloma to include novel validated biomarkers that are associated with the development of CRAB features ([[hypercalcaemia]], [[renal failure]], [[anaemia]], and [[bone]] lesions). The update also clarified the underlying laboratory and radiographic findings of CRAB features, as well as the histological and monoclonal protein requirements for the disease diagnosis.<ref name=lancet>Rajkumar, S. Vincent, Meletios A. Dimopoulos, Antonio Palumbo, Joan Blade, Giampaolo Merlini, María-Victoria Mateos, Shaji Kumar et al. "International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma." The Lancet Oncology 15, no. 12 (2014): e538-e548</ref> | ||
===Revised Criteria for the Diagnosis of Multiple Myeloma<SMALL><ref name=lancet>Rajkumar, S. Vincent, Meletios A. Dimopoulos, Antonio Palumbo, Joan Blade, Giampaolo Merlini, María-Victoria Mateos, Shaji Kumar et al. "International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma." The Lancet Oncology 15, no. 12 (2014): e538-e548</ref></SMALL>=== | ===Revised Criteria for the Diagnosis of Multiple Myeloma<SMALL><ref name=lancet>Rajkumar, S. Vincent, Meletios A. Dimopoulos, Antonio Palumbo, Joan Blade, Giampaolo Merlini, María-Victoria Mateos, Shaji Kumar et al. "International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma." The Lancet Oncology 15, no. 12 (2014): e538-e548</ref></SMALL>=== | ||
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* Evidence of end organ damage that can be attributed to the underlying plasma cell proliferative disorder: | * Evidence of end organ damage that can be attributed to the underlying plasma cell proliferative disorder: | ||
::* '''Hypercalcemia''': serum calcium >0·25 mmol/L (>1 mg/dL) higher than the upper limit of normal or >2·75 mmol/L (>11 mg/dL) | ::* '''Hypercalcemia''': serum calcium >0·25 mmol/L (>1 mg/dL) higher than the upper limit of normal or >2·75 mmol/L (>11 mg/dL) | ||
::* '''Renal insufficiency''': creatinine clearance <40 mL per min or serum creatinine > 177 μmol/L (>2 mg/dL) | ::* '''Renal insufficiency''': creatinine clearance <40 mL per min or serum creatinine >177 μmol/L (>2 mg/dL) | ||
::* '''Anemia''': hemoglobin value of >20 g/L below the lower limit of normal, or a hemoglobin value <100 g/L | ::* '''Anemia''': hemoglobin value of >20 g/L below the lower limit of normal, or a hemoglobin value <100 g/L | ||
::* '''Bone lesion''': one or more osteolytic lesions on skeletal radiography, CT, or PET-CT | ::* '''Bone lesion''': one or more osteolytic lesions on skeletal radiography, CT, or PET-CT | ||
Revision as of 18:31, 23 September 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Serge Korjian M.D.
Overview
The International Myeloma Working Group (IMWG) proposed updated criteria for the diagnosis of multiple myeloma in November 2014. The diagnosis requires >10% clonal plasma cell proliferation in the bone marrow, or biopsy-proven plasmacytosis at an extramedullary site plus one of more of the multiple myeloma-defining CRAB features (hypercalcemia, renal failure, anaemia, and bone lesions) or one or more of the newly added biomarkers of malignancy (clonal bone marrow plasma cell percentage ≥60%, involved:uninvolved serum free light chain ratio ≥100, and >1 focal lesions on MRI studies).[1]
Diagnostic Criteria
In November 2014, the International Myeloma Working Group (IMWG) updated the criteria for the diagnosis of multiple myeloma to include novel validated biomarkers that are associated with the development of CRAB features (hypercalcaemia, renal failure, anaemia, and bone lesions). The update also clarified the underlying laboratory and radiographic findings of CRAB features, as well as the histological and monoclonal protein requirements for the disease diagnosis.[1]
Revised Criteria for the Diagnosis of Multiple Myeloma[1]
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≥10% clonal expansion of bone marrow plasma cells or biopsy-proven bony or extramedullary plasmacytoma and one or more of the following features:
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Criteria for the Diagnosis of Smouldering Multiple Myeloma[1]
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Both criteria must be met:
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