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Lancet Oncol. 2014 Nov;15(12):e538-48. doi: 10.1016/S1470-2045(14)70442-5. Epub 2014 Oct 26.

International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma.

Author information

1
Division of Hematology, Mayo Clinic, Rochester, MN, USA. Electronic address: rajkumar.vincent@mayo.edu.
2
Department of Clinical Therapeutics, University of Athens, School of Medicine, Athens, Greece.
3
Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy.
4
Hospital Clinic, Barcelona, Spain.
5
Amyloidosis Center, University Hospital Policlinico San Matteo, Pavia, Italy.
6
University Hospital of Salamanca/IBSAL, Salamanca, Spain.
7
Division of Hematology, Mayo Clinic, Rochester, MN, USA.
8
Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany.
9
Dana-Farber Cancer Institute, Boston, MA, USA.
10
Memorial Sloan Kettering Cancer Center, New York, NY, USA.
11
Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), Pamplona, Spain.
12
Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA.
13
University Hospital of Lille, Lille, France.
14
Department of Hematology, VU University Medical Center, Amsterdam, Netherlands.
15
Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, USA.
16
Seràgnoli Institute of Hematology, Bologna University School of Medicine, Bologna, Italy.
17
Mount Sinai Cancer Institute, New York, NY, USA.
18
Memorial Hospital, Istanbul, Turkey.
19
Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
20
Department of Hematology, CHU de Liege, Liege, Belgium.
21
Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC, USA.
22
Servicio de Hematología, Hospital Universitario 12 de Octubre, Madrid, Spain.
23
Department of Haematology, Aalborg University Hospital, Aalborg, Denmark.
24
Ankara University School of Medicine, Ankara, Turkey.
25
Cedars-Sinai Comprehensive Cancer Center, Los Angeles, CA, USA.

Abstract

This International Myeloma Working Group consensus updates the disease definition of multiple myeloma to include validated biomarkers in addition to existing requirements of attributable CRAB features (hypercalcaemia, renal failure, anaemia, and bone lesions). These changes are based on the identification of biomarkers associated with near inevitable development of CRAB features in patients who would otherwise be regarded as having smouldering multiple myeloma. A delay in application of the label of multiple myeloma and postponement of therapy could be detrimental to these patients. In addition to this change, we clarify and update the underlying laboratory and radiographic variables that fulfil the criteria for the presence of myeloma-defining CRAB features, and the histological and monoclonal protein requirements for the disease diagnosis. Finally, we provide specific metrics that new biomarkers should meet for inclusion in the disease definition. The International Myeloma Working Group recommends the implementation of these criteria in routine practice and in future clinical trials, and recommends that future studies analyse any differences in outcome that might occur as a result of the new disease definition.

PMID:
25439696
DOI:
10.1016/S1470-2045(14)70442-5
[Indexed for MEDLINE]
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