key papersKey paper
IMWG updated criteria for the diagnosis of multiple myeloma (2014)
The 2014 International Myeloma Working Group criteria allow myeloma to be diagnosed and treated before organ damage occurs when biomarkers such as 60 percent marrow plasma cells or a very high light-chain ratio predict imminent progression.
Overview
Updated diagnostic criteria adding three myeloma-defining biomarkers (clonal marrow plasma cells 60 percent or more, involved to uninvolved free light chain ratio 100 or more, more than one focal lesion on MRI) to the classic CRAB features, and revising the definitions of smouldering myeloma and related plasma cell disorders.
GuidelineChanged practice
Authors
Rajkumar SV, Dimopoulos MA, Palumbo A, et al.
Published
The Lancet Oncology, 2014
What it means
Whether a patient is labelled smouldering or active myeloma, and therefore whether treatment starts, depends on these criteria.
Caveats
- Biomarker thresholds were based on retrospective cohorts and continue to be refined.