{"id":5632,"date":"2018-03-22T13:07:40","date_gmt":"2018-03-22T13:07:40","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/?p=987"},"modified":"2026-02-26T19:44:41","modified_gmt":"2026-02-26T19:44:41","slug":"multiple-myeloma","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/multiple-myeloma\/","title":{"rendered":"Revised IMWG 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>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).<\/p>\n<p><!--more--><strong>Revised International Myeloma Working Group diagnostic criteria for multiple<\/strong><br \/>\n<strong>myeloma and smouldering multiple myeloma<\/strong><\/p>\n<p><strong>Definition of multiple myeloma<\/strong><br \/>\nClonal bone marrow plasma cells \u226510% or biopsy-proven bony or extramedullary<br \/>\nplasmacytoma* and any one or more of the following myeloma defining events:<\/p>\n<ul>\n<li>Myeloma defining events:\n<ul style=\"list-style-type: disc;\">\n<li>Evidence of end organ damage that can be attributed to the underlying plasma cell proliferative disorder, specifically:\n<ul style=\"list-style-type: circle;\">\n<li>Hypercalcaemia: serum calcium &gt;0.25 mmol\/L (&gt;1 mg\/dL) higher than the upper limit of normal or &gt;2.75 mmol\/L (&gt;11 mg\/dL)<\/li>\n<li>Renal insufficiency: creatinine clearance &lt;40 mL per min\u2020 or serum creatinine &gt;177 \u03bcmol\/L (&gt;2 mg\/dL)<\/li>\n<li>Anaemia: haemoglobin value of &gt;20 g\/L below the lower limit of normal, or a haemoglobin value &lt;100 g\/L<\/li>\n<li>Bone lesions: one or more osteolytic lesions on skeletal radiography, CT, or PET-CT\u2021<\/li>\n<\/ul>\n<\/li>\n<li>Any one or more of the following biomarkers of malignancy:\n<ul style=\"list-style-type: circle;\">\n<li>Clonal bone marrow plasma cell percentage* \u226560%<\/li>\n<li>Involved:uninvolved serum free light chain ratio\u00a7 \u2265100<\/li>\n<li>&gt;1 focal lesions on MRI studies\u00b6<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><strong>Definition of smouldering multiple myeloma<\/strong><\/p>\n<p>Both criteria must be met:<\/p>\n<ul>\n<li>Serum monoclonal protein (IgG or IgA) \u226530 g\/L or urinary monoclonal protein \u2265500 mg per 24 h and\/or clonal bone marrow plasma cells 10\u201360%<\/li>\n<li>Absence of myeloma defining events or amyloidosis<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>PET-CT=\u00b9\u2078F-fluorodeoxyglucose PET with CT.<br \/>\n*Clonality should be established by showing \u03ba\/\u03bb-light-chain restriction on flow cytometry, immunohistochemistry, or immunofluorescence. Bone marrow plasma cell percentage should preferably be estimated from a core biopsy specimen; in case of a disparity between the aspirate and core biopsy, the highest value should be used. \u2020Measured or estimated by validated equations. \u2021If bone marrow has less than 10% clonal plasma cells, more than one bone lesion is required to distinguish from solitary plasmacytoma with minimal marrow involvement. \u00a7These values are based on the serum Freelite assay (The Binding Site Group, Birmingham, UK). The involved free light chain must be \u2265100 mg\/L. \u00b6Each focal lesion must be 5 mm or more in size.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>References:<\/strong><\/p>\n<ol>\n<li>Rajkumar SV, Dimopoulos MA, Palumbo A, Blade J, Merlini G, Mateos MV, Kumar S, Hillengass J, Kastritis E, Richardson P, Landgren O, Paiva B, Dispenzieri A, Weiss B, LeLeu X, Zweegman S, Lonial S, Rosinol L, Zamagni E, Jagannath S, Sezer O, Kristinsson SY, Caers J, Usmani SZ, Lahuerta JJ, Johnsen HE, Beksac M, Cavo M, Goldschmidt H, Terpos E, Kyle RA, Anderson KC, Durie BG, Miguel JF. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma.\u00a0Lancet Oncol. 2014 Nov;15(12):e538-48. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/25439696\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Rajkumar SV. Updated Diagnostic Criteria and Staging System for Multiple Myeloma.\u00a0Am Soc Clin Oncol Educ Book. 2016;35:e418-23. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/27249749\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Zorlu T, Kayer MA, Okumus N, Ula\u015f T, Dal MS, Altuntas F. Challenges, Difficulties, and Delayed Diagnosis of Multiple Myeloma. Diagnostics (Basel). 2025 Jul 4;15(13):1708. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/40647707\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Created Mar 21, 2018.<br \/>\nUp-date Feb 26, 2026.<\/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":[16,15,14,13,1536,2015,1304,1065,755,469,754,8,7,2016],"class_list":["post-5632","post","type-post","status-publish","format-standard","hentry","category-hematology","tag-criteria","tag-criterios","tag-diagnostic","tag-diagnostico","tag-group","tag-imwg","tag-internacional","tag-international","tag-mieloma","tag-multiple","tag-myeloma","tag-revisados","tag-revised","tag-working"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.1 - 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