Multiple myeloma classification: Difference between revisions
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==Classification== | ==Classification== | ||
In 2003, the International Myeloma Working Group agreed on diagnostic criteria for symptomatic myeloma, asymptomatic myeloma and [[monoclonal gammopathy of undetermined significance|MGUS]] (monoclonal gammopathy of undetermined significance): | |||
* Symptomatic myeloma: | |||
*# Clonal plasma cells >10% on [[bone marrow]] [[biopsy]] or (in any quantity) in a biopsy from other tissues ([[plasmacytoma]]) | |||
*# A [[monoclonal]] protein ([[paraprotein]]) in either [[blood plasma|serum]] or [[urine]] | |||
*# Evidence of end-organ damage (''related organ or tissue impairment'', ROTI): | |||
*#* [[Hypercalcemia]] (corrected calcium >2.75 mmol/L) | |||
*#* [[Renal insufficiency]] attributable to myeloma | |||
*#* [[Anemia]] (hemoglobin <10 g/dL) | |||
*#* Bone [[lesions]] (lytic lesions or [[osteoporosis]] with compression fractures) | |||
*#* Frequent severe [[infections]] (>2 a year) | |||
*#* [[Amyloidosis]] of other organs | |||
*#* [[Hyperviscosity syndrome]] | |||
* Asymptomatic myeloma: | |||
*# Serum paraprotein >30 g/L AND/OR | |||
*# Clonal plasma cells >10% on bone marrow biopsy AND | |||
*# NO myeloma-related organ or tissue impairment | |||
* Monoclonal gammopathy of undetermined significance (MGUS): | |||
*# Serum paraprotein <30 g/L AND/OR | |||
*# Clonal plasma cells <10% on bone marrow biopsy AND | |||
*# NO myeloma-related organ or tissue impairment | |||
Related conditions include ''solitary [[plasmacytoma]]'' (a single tumor of plasma cells, typically treated with irradiation), ''plasma cell [[dyscrasia]]'' (where only the antibodies produce symptoms, e.g. AL [[amyloid|amyloidosis]]), and [[POEMS syndrome]] (peripheral neuropathy, organomegaly, endocrinopathy, monoclonal plasma cell disorder, skin changes). | |||
Multiple myeloma is classified according to the site of involvement into: | Multiple myeloma is classified according to the site of involvement into: | ||
<ref name="pmid10357398">{{cite journal| author=Alexiou C, Kau RJ, Dietzfelbinger H, Kremer M, Spiess JC, Schratzenstaller B et al.| title=Extramedullary plasmacytoma: tumor occurrence and therapeutic concepts. | journal=Cancer | year= 1999 | volume= 85 | issue= 11 | pages= 2305-14 | pmid=10357398 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10357398 }} </ref> | <ref name="pmid10357398">{{cite journal| author=Alexiou C, Kau RJ, Dietzfelbinger H, Kremer M, Spiess JC, Schratzenstaller B et al.| title=Extramedullary plasmacytoma: tumor occurrence and therapeutic concepts. | journal=Cancer | year= 1999 | volume= 85 | issue= 11 | pages= 2305-14 | pmid=10357398 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10357398 }} </ref> | ||
Revision as of 17:01, 21 September 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2]
Overview
- Multiple myeloma may be classified into two subtypes based on the extent of malignant cell spread outside the bone marrow.
Classification
In 2003, the International Myeloma Working Group agreed on diagnostic criteria for symptomatic myeloma, asymptomatic myeloma and MGUS (monoclonal gammopathy of undetermined significance):
- Symptomatic myeloma:
- Clonal plasma cells >10% on bone marrow biopsy or (in any quantity) in a biopsy from other tissues (plasmacytoma)
- A monoclonal protein (paraprotein) in either serum or urine
- Evidence of end-organ damage (related organ or tissue impairment, ROTI):
- Hypercalcemia (corrected calcium >2.75 mmol/L)
- Renal insufficiency attributable to myeloma
- Anemia (hemoglobin <10 g/dL)
- Bone lesions (lytic lesions or osteoporosis with compression fractures)
- Frequent severe infections (>2 a year)
- Amyloidosis of other organs
- Hyperviscosity syndrome
- Asymptomatic myeloma:
- Serum paraprotein >30 g/L AND/OR
- Clonal plasma cells >10% on bone marrow biopsy AND
- NO myeloma-related organ or tissue impairment
- Monoclonal gammopathy of undetermined significance (MGUS):
- Serum paraprotein <30 g/L AND/OR
- Clonal plasma cells <10% on bone marrow biopsy AND
- NO myeloma-related organ or tissue impairment
Related conditions include solitary plasmacytoma (a single tumor of plasma cells, typically treated with irradiation), plasma cell dyscrasia (where only the antibodies produce symptoms, e.g. AL amyloidosis), and POEMS syndrome (peripheral neuropathy, organomegaly, endocrinopathy, monoclonal plasma cell disorder, skin changes). Multiple myeloma is classified according to the site of involvement into: [1]
- Medullary multiple myeloma
- Extramedullary multiple myeloma
References
- ↑ Alexiou C, Kau RJ, Dietzfelbinger H, Kremer M, Spiess JC, Schratzenstaller B; et al. (1999). "Extramedullary plasmacytoma: tumor occurrence and therapeutic concepts". Cancer. 85 (11): 2305–14. PMID 10357398.