ﺑﺎﺯﮔﺸﺖ ﺑﻪ ﺻﻔﺤﻪ ﻗﺒﻠﯽ
خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
نسخه الکترونیک
medimedia.ir

Revised International Myeloma Working Group diagnostic criteria for multiple myeloma and smoldering multiple myeloma

Revised International Myeloma Working Group diagnostic criteria for multiple myeloma and smoldering multiple myeloma
Definition of multiple myeloma
Clonal bone marrow plasma cells ≥10% or biopsy-proven bony or extramedullary plasmacytoma* and any one or more of the following myeloma-defining events:
  • Evidence of end-organ damage that can be attributed to the underlying plasma cell proliferative disorder, specifically:
    • Hypercalcemia: serum calcium >0.25 mmol/L (>1 mg/dL) higher than the upper limit of normal or >2.75 mmol/L (>11 mg/dL)
    • Renal insufficiency: creatinine clearance <40 mL per min or serum creatinine >177 µmol/L (>2 mg/dL)
    • Anemia: hemoglobin value of >20 g/L below the lower limit of normal, or a hemoglobin value <100 g/L
    • Bone lesions: one or more osteolytic lesions on skeletal radiography, CT, or PET-CTΔ
  • Any one or more of the following biomarkers of malignancy:
    • Clonal bone marrow plasma cell percentage* ≥60%
    • Involved:uninvolved serum free light chain ratio ≥100
    • >1 focal lesions on MRI studies§
Definition of smoldering multiple myeloma
Both criteria must be met:
  • Serum monoclonal protein (IgG or IgA) ≥30 g/L or urinary monoclonal protein ≥500 mg per 24 hours and/or clonal bone marrow plasma cells 10 to 59%
  • Absence of myeloma defining events or amyloidosis
Definition of monoclonal gammopathy of undetermined significance
All three criteria must be met:
  • Serum monoclonal protein <30 g/L
  • Bone marrow plasma cells <10%
  • Absence of myeloma defining events or amyloidosis (or Waldenström macroglobulinemia in the case of IgM MGUS)

PET-CT: 18F-fluorodeoxyglucose positron emission tomography with computed tomography.

* Clonality should be established by showing kappa/lambda-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.

¶ Measured or estimated by validated equations.

Δ If 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.

◊ These values are based on the serum Freelite assay (The Binding Site Group, Birmingham, UK). The involved free light chain must be ≥100 mg/L.

§ Each focal lesion must be 5 mm or more in size.
Original figure modified for this publication. Rajkumar SV, Dimopoulos MA, Palumbo A, et al. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol 2014; 15:e538. Table used with the permission of Elsevier Inc. All rights reserved.
Graphic 57627 Version 15.0

آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟