Diagnosing Myeloma Early: New IMWG Guidelines
For some time, members of the International Myeloma Working Group (IMWG), the IMF's research division, have been trying to identify and describe a group of patients without CRAB features. Finally, Dr. Vincent Rajkumar, my co-chair in this project, has succeeded in bringing together the data, plus ideas and opinions from the IMWG members, to create new diagnostic criteria for myeloma. The criteria define a new "Pre-CRAB" group of patients who need treatment. A paper detailing the IMWG's updated criteria was published today in the journal Lancet Oncology.
This step forward has many important implications, not the least of which is the expectation that earlier treatment will lead to better outcomes! This is the central idea of the IMF's signature Black Swan Research Initiative, in which early treatment is combined with close assessment of low levels of residual myeloma--minimal residual disease (MRD) testing--to push for therapy to achieve an MRD negative status that can lead to a cure.
The IMWG's updated criteria represent no less than "a paradigm shift in myeloma," said Dr. Rajkumar in a video interview. "We are now willing to treat myeloma before symptoms happen. This is a big deal."