Multiple myeloma diagnostic criteria

Multiple myeloma Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Multiple Myeloma from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Criteria
Staging
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X Ray
Echocardiograph and Ultrasound
CT
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Future or Investigational Therapies
Case Studies
Case #1
Multiple myeloma diagnostic criteria On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Multiple myeloma diagnostic criteria All Images X-rays Echo and Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Multiple myeloma diagnostic criteria
CDC on Multiple myeloma diagnostic criteria
Multiple myeloma diagnostic criteria in the news
Blogs on Multiple myeloma diagnostic criteria
Directions to Hospitals Treating Multiple myeloma
Risk calculators and risk factors for Multiple myeloma diagnostic criteria

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).

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.

Revised Criteria for the Diagnosis of Multiple Myeloma

“

≥10% clonal expansion of bone marrow plasma cells or biopsy-proven bony or extramedullary plasmacytoma and one or more of the following features: 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) 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 Bone lesion: one or more osteolytic lesions on skeletal radiography, CT, or PET-CT Any one or more of the following biomarkers of malignancy: Clonal bone marrow plasma cell percentage ≥60% Involved:uninvolved serum free light chain ratio ≥100 >1 focal lesions on MRI studies

”

Criteria for the Diagnosis of Smouldering Multiple Myeloma

“

Both criteria must be met: Serum monoclonal protein (IgG or IgA) ≥30 g/L or urinary monoclonal protein ≥500 mg per 24 h and/or clonal bone marrow plasma cells 10–60% Absence of multiple myeloma-defining events or amyloidosis

”