Multiple Myeloma: Criteria for Diagnosis and Response to Therapy
Multiple myeloma is a B-cell malignancy characterized by a monoclonal expansion and accumulation of abnormal plasma cells in the bone marrow. The clinical manifestations of myeloma include bone complications, symptoms of impaired hemopoiesis, renal impairment, symptoms of hyperviscosity, infections, peripheral neuropathy, and symptoms of extramedullary disease. The International Myeloma Study Group has recently published new criteria for the diagnosis of active myeloma nad for response to therapy. The new diagnostic criteria include, in the well known CRAB criteria, the presence of lytic disease revealed not only by conventional radiography but also by computed tomography (CT) or positron emission tomography (PET)-CT and also the presence of eGFR of below 40 ml/min due to myeloma. Furthermore other diagnostic criteria include in the absence of CRAB: presence of more than one focal lesion in the magnetic resonance imaging of the whole skeleton, more than 60% infiltration of the bone marrow by plasma cells and the free light chain ratio of more than 100. The new response criteria include minimal residual disease criteria both in the bone marrow (next generation sequencing or next generation flow cytometry) and outside the bone marrow (PET-CT).
- 2.Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J, Vardiman J (eds) (2008) World Health Organization classification of tumours of haematopoietic and lymphoid tissues, 4th edn. IARC Press, LyonGoogle Scholar
- 6.Katodritou E, Vadikolia C, Lalagianni C et al (2014) “Real-world” data on the efficacy and safety of lenalidomide and dexamethasone in patients with relapsed/refractory multiple myeloma who were treated according to the standard clinical practice: a study of the Greek myeloma study group. Ann Hematol 93:129–139CrossRefGoogle Scholar