Multiple myeloma classification
|
Multiple myeloma Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Multiple myeloma classification On the Web |
|
American Roentgen Ray Society Images of Multiple myeloma classification |
|
Risk calculators and risk factors for Multiple myeloma classification |
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.