{"id":2550,"date":"2009-03-02T02:33:35","date_gmt":"2009-03-02T02:33:35","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/hemmm\/"},"modified":"2025-05-14T19:11:26","modified_gmt":"2025-05-14T19:11:26","slug":"hemmm","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/hemmm\/","title":{"rendered":"Diagnostic Criteria for Multiple Myeloma"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p><\/p>\n<div class=\"Section1\">\n<p class=\"MsoNormal\" align=\"justify\">Presence of an M-component<sup>a<\/sup> in serum and\/or urine plus clonal plasma cells in the bone marrow and\/or a documented clonal plasmacytoma.<\/p>\n<p><!--more--><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\" align=\"justify\">PLUS one or more of the following:<sup>b<\/sup><\/p>\n<ul>\n<li>Calcium elevation (&gt;11.5 mg\/dl) [&gt;2.65 mmol\/l]<\/li>\n<li>Renal insufficiency (creatinine &gt;2 mg\/dl) [177 mmol\/l or more]<\/li>\n<li>Anemia (hemoglobin &lt;10 g\/dl or 2 g\/dl &lt;normal) (hemoglobin &lt;12.5 mmol\/l<sup>c<\/sup> or 1.25 mmol\/l &lt;normal)<\/li>\n<li>Bone disease (lytic lesions or osteopenia)<\/li>\n<\/ul>\n<p class=\"MsoNormal\" align=\"justify\"><sup>a<\/sup>In patients with no detectable M-component, an abnormal serum FLC ratio on the serum FLC assay can substitute and satisfy this criterion. For patients, with no serum or urine M-component and normal serum FLC ratio, the baseline bone marrow must have <span style=\"text-decoration: underline;\">&gt;<\/span>10% clonal plasma cells; these patients are referred to as having \u2018non-secretory myeloma\u2019. Patients with biopsy-proven amyloidosis and\/or systemic light chain deposition disease (LCDD) should be classified as \u2018myeloma with documented amyloidosis\u2019 or \u2018myeloma with documented LCDD,\u2019 respectively if they have <span style=\"text-decoration: underline;\">&gt;<\/span>30% plasma cells and\/or myeloma-related bone disease.<\/p>\n<p class=\"MsoNormal\" align=\"justify\"><sup>b<\/sup>Must be attributable to the underlying plasma cell disorder.<\/p>\n<p class=\"MsoNormal\" align=\"justify\"><sup>c<\/sup>Note: Hemoglobin of 10 g\/dl is 12.5 mmol\/l [or 100 g\/l].<\/p>\n<p class=\"MsoNormal\">\n<\/div>\n<div class=\"Section1\"><\/div>\n<div class=\"Section1\">\n<div class=\"Section1\">\n<div class=\"Section1\">\n<p style=\"margin-top: 0pt; margin-bottom: 0pt;\"><strong>Myeloma-related organ dysfunction (CRAB criteria)<\/strong><\/p>\n<ul>\n<li>Hypercalcemia (serum calcium &gt;11.5 mg\/dl [2.88 mmol\/liter])<\/li>\n<li>Renal insufficiency (serum creatinine &gt;2 mg\/dl [177 umol\/liter])<\/li>\n<li>Anemia (hemoglobin &lt;10 g\/dl or &gt;2 g\/dl below the lower limit of the normal range)<\/li>\n<li>Bone disease (lytic lesions, severe osteopenia, or pathologic fracture)<\/li>\n<\/ul>\n<p style=\"margin-top: 0pt; margin-bottom: 0pt;\"><strong>International Staging System<\/strong><\/p>\n<ul>\n<li>Stage I: serum B2-microglobulin &lt;3.5 mg\/liter, serum albumin &gt;\/=3.5 g\/dl<\/li>\n<li>Stage II: serum B2-microglobulin, &lt;3.5mg\/liter plus serum albumin &lt;3.5 g\/dl; or serum B2-microglobulin 3.5 to &lt;5.5 mg\/liter regardless of serum albumin level<\/li>\n<li>Stage III: serum B2-microglobulin &gt;\/=5.5 mg\/liter<\/li>\n<\/ul>\n<p style=\"margin-top: 0pt; margin-bottom: 0pt;\"><strong>Chromosomal abnormalities<\/strong><\/p>\n<ul>\n<li>High-risk: presence of t(4;14) or deletion 17p13 detected by fluorescence in situ hybridization<\/li>\n<li>Standard-risk: t(11;14) detected by fluorescence in situ hybridization<\/li>\n<\/ul>\n<div class=\"Section1\">\n<p>&nbsp;<\/p>\n<p class=\"MsoNormal\"><strong>References:<\/strong><\/p>\n<ol>\n<li>Durie BG, Harousseau JL, Miguel JS, Blad\u00e9 J, Barlogie B, Anderson K, Gertz M, Dimopoulos M, Westin J, Sonneveld P, Ludwig H, Gahrton G, Beksac M, Crowley J, Belch A, Boccadaro M, Cavo M, Turesson I, Joshua D, Vesole D, Kyle R, Alexanian R, Tricot G, Attal M, Merlini G, Powles R, Richardson P, Shimizu K, Tosi P, Morgan G, Rajkumar SV; International Myeloma Working Group. International uniform response criteria for multiple myeloma.\u00a0Leukemia. 2006 Sep;20(9):1467-73.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/16855634\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<li>Palumbo A, Anderson K. Multiple myeloma. N Engl J Med. 2011 Mar 17;364(11):1046-60.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/21410373\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<\/ol>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<p>Created: Jun 17, 2007<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[171],"tags":[16,15,14,13,1381,755,469,754],"class_list":["post-2550","post","type-post","status-publish","format-standard","hentry","category-hematology","tag-criteria","tag-criterios","tag-diagnostic","tag-diagnostico","tag-hematology","tag-mieloma","tag-multiple","tag-myeloma"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2550","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=2550"}],"version-history":[{"count":3,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2550\/revisions"}],"predecessor-version":[{"id":9121,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2550\/revisions\/9121"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=2550"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=2550"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=2550"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}