This is a comprehensive, stateoftheart guide to the diagnosis, treatment, and biology of multiple myeloma and related plasma disorders. Monitor for multiple myeloma symptoms and m protein serum and. Multiple myeloma differential diagnoses medscape reference. Diagnosing multiple myeloma includes blood work, a 24hour urine collection, a bone marrow biopsy, imaging studies such as xrays, mris, pet scans and bone density. A physical exam and full medical history evaluation including urine test a complete blood count cbc that will. Myeloma associated al amyloidosis is reported in 1230% of multiple myeloma patients. Group revised the diagnostic criteria for multiple myeloma. Pdf multiple myeloma is characterised by the proliferation of malignant. Downloaded from the american family physician web site at. Review article multiple myeloma world health organization. Patients with serum free light chain ratio 100 7 15% of patients patients with 1 lesion on whole body mri scan. Imwg criteria for the diagnosis of myeloma and guidelines.
International myeloma working group updated criteria for. In 2006 guidelines for the diagnosis and management of multiple myeloma were published smith et al, 2006. Pdf multiple myeloma mm is a plasma cell dyscrasia that accounts. Beside the one in the multiple myeloma diagnostic calculator above, there is the international myeloma working group diagnostic criteria. Diagnostic and response criteria volume 15, supplement 3, e4e5, september 01. Criteria for diagnosis, staging, risk stratification and response.
Multiple myeloma is often diagnosed based on tests, the patients symptoms and the doctors physical exam of the patient. The diagnostic criteria for mm were revised in 2014 to include 3. Multiple myeloma mm is a debilitating malignancy that is part of a spectrum of diseases ranging from monoclonal gammopathy of unknown significance mgus to plasma cell leukemia. Pdf an approach to the diagnosis and management of multiple. International myeloma working group imwg updated the diagnostic criteria for.
Presence of an mcomponent a in serum andor urine plus clonal plasma cells in the bone marrow andor a documented. The criteria for diagnosis of mm were updated in 2014 by the. Diagnostic criteria definitions of response definitions of relapse 1% are nonsecretory. Relapses continue at 7%year, high transplantrelated mortality 30%. Multiple myeloma algorithm md anderson cancer center. The calculator for multiple myeloma diagnostic criteria uses parameters to make a diagnosis. Myeloma is called multiple because it frequently involves multiple areas in the body. This is a bone marrow aspirate from a patient with multiple myeloma showing the abnormal accumulation of malignan plasma cells. Multiple myeloma atlas of genetics and cytogenetics in.
Monoclonal m spike on electrophoresis igg 3,5gdl, iga 2gdl, light chain 1gdl in 24h urine sample minor criteria a. International myeloma working group imwg updated criteria for. Evolving diagnostic criteria for multiple myeloma hematology. Normally, plasma cells produce antibodies and play a key role in immune function. There has been remarkable progress made in the diagnosis and treatment of multiple myeloma mm. Smoldering multiple myeloma diagnostic 10% clonal marrow plasma cells 10% to 60% clonal marrow plasma cells high circulating clonal plasma cells by.
Multiple myeloma dr harpreet singh bhatia dmch, ludhiana,punjab 2. The mprotein monoclonal immunoglobulin protein produced by the malignant plasma cells is igg in about 55% of myeloma patients and iga in about 20%. People with mgus monoclonal gammopathy of unknown significance or solitary. Multiple myeloma mm is a cancer of plasma cells in the bone marrow. Criteria for diagnosis, staging, risk stratification and. Diagnosing multiple myeloma usually begins with a visit to your family doctor. These patients typically fulfill the diagnostic criteria for multiple myeloma and have evidence of amyloid light chain.
Pdf multiple myeloma is characterised by the proliferation of. Updated diagnostic criteria and staging system for multiple myeloma. Tests to find multiple myeloma american cancer society. The diagnostic and response criteria recommended are primarily derived from the international. Immunoglobulin free light chain ratio is an independent risk factor for progression of smoldering asymptomatic multiple myeloma.
Kyle, md the diagnosis of multiple myeloma often begins with the recognition of a monoclonal protein in the serum or urine or both. Malignanat b cell lymphoproliferative disorder of the marrow with plasma. Updated diagnostic criteria and staging system for. Imwg diagnostic criteria for mm and related plasma cell disorders. Free download myeloma powerpoint presentation slides. International myeloma working group imwg criteria for the diagnosis of multiple myeloma. New diagnostic criteria for multiple myeloma clinical lymphoma. The diagnosis of active multiple myeloma requires the presence of endorgan damage. The patient handbook focuses on the questions and decisions that a newly diagnosed patient faces. In november 2014, the international myeloma working group imwg updated the criteria for the diagnosis of. Diagnosis of multiple myeloma canadian cancer society. Diagnostic criteria for multiple myeloma major criteria i. For decades the diagnosis of multiple myeloma required the presence of endorgan damage.
Imwg criteria for the diagnosis of myeloma and guidelines for the diagnostic workup of myeloma criteria for a diagnosis of myeloma followed by the examinations, tests, and imaging studies that are. Serum monoclonal protein igg or iga greater than or equal to 30 gl or urinary monoclonal protein greater. Edited and written by a multidisciplinary group of recognized. Multiple myeloma 2016 boca raton regional hospital.
Medical criteria, definitions, indications, contraindications, classifications, diagnosis. The parameters include plasmacytoma on tissue biopsy, bone marrow plasmacytosis, m protein, urinary. This answer is based on the plasma cell myeloma chapter from the classification of tumours published by the world health organization. The most common presenting symptoms of mm are fatigue and bone or back pain. Criteria for the classification of monoclonal gammopathies, multiple myeloma and related disorders. Updated criteria for the diagnosis of multiple myeloma managing. Patients may present with bone pain or with symptoms that are often nonspecific, such as nausea. Diagnostic criteria of multiple myeloma sciencedirect. The median survival of the disease has doubled as a result of several new active. Multiple myeloma response criteria forms instruction. You will find a list of common tests, procedures, and scans that doctors use to find the cause of a medical problem.
Multiple myeloma, the most common bone malignancy, is occurring with increasing frequency in older persons. Imwg criteria for the diagnosis of mm inl myeloma fn. Multiple myeloma mm, also known as plasma cell myeloma and simple myeloma, is a cancer of plasma cells, a type of white blood cell that normally produces antibodies. Definitions smoldering asymptomatic myeloma both criteria must be met. Multiple myeloma can be difficult to diagnose because its an uncommon type of cancer that usually has few or no symptoms in the early stages. New diagnostic criteria for multiple myeloma clinical.
Multiple myeloma cells typically grow within the bm of the spine, skull, ribs, sternum, pelvis, humeri, and. Freelite serum free light chain assay measure antibody light chains made by. Note, the second bullet point above was previously available in this section as a. There are wide variations of myeloma subtypes including inactive and active types of myeloma, and in active myeloma, nonaggresive and aggressive types of myeloma. These current guidelines represent a major revision. Multiple myeloma early detection, diagnosis, and staging. Understanding mgus and smoldering multiple myeloma. It may present with myriad complications including anaemia, hypercalcaemia, renal failure, recurrent infections or bony lytic. The international myeloma working group imwg has updated the diagnostic criteria for mm in 2014, adding 3 specific biomarkers that. New diagnostic criteria for myeloma nssg haematology. Multiple myeloma is a type of cancer caused by malignant plasma cells in your bone marrow.
New systems have emerged for diagnosis, staging and response assessment in multiple myeloma mm. Multiple myeloma mm, also known as symptomatic plasma cell myeloma, is a plasma cell malignancy. Multiple myeloma mm has been traditionally defined by the presence of. Multiple myeloma can present with a wide constellation of symptoms including. Added the bullet points below to general reporting guidelines. Different types of multiple myeloma the myeloma crowd. Multiple myeloma mm has been traditionally defined by the presence of endorgan damage, specifically, hypercalcemia, renal failure, anemia, and bone lesions crab features that are felt to be a consequence of the underlying clonal plasma cell proliferation.
653 150 1475 50 1160 321 184 1456 487 968 927 923 928 1397 1054 199 1326 670 473 337 687 677 65 261 229 1379 1522 1310 3 1215 323 68 246 1331 500 508 1349