The International Myeloma Working Group’s (IMWG) summaries focus on guidelines and statements about certain aspects of multiple myeloma. The IMWG's research on multiple myeloma studies its causes, how to stage the disease, and how to achieve remission. The following are a few of the topics that the IMWG covers: 

  • vertebral augmentation
  • treatment-emergent peripheral neuropathy
  • facilities and services for myeloma patients
  • using bisphosphonates

With new and upcoming information about myeloma and its treatments, the International Myeloma Working Group’s summaries clarify upcoming data in an easier way. These summaries also focus on myeloma’s classifications, different types of myeloma, what influences myeloma to become active as well as managing the side effects of treatment.

The updated criteria for the diagnosis of myeloma represent a paradigm shift in the approach to myeloma and have considerable impact on the management of the disease.

The incidence, symptoms, reversibility, and predisposing factors of treatment-emergent peripheral neuropathy (PN) vary among myeloma therapies. PN incidence is affected by treatment dose and schedule, by combinations of potentially neurotoxic agents, and by patient characteristics.

There has been much controversy in over two decades about the role of allogeneic stem cell transplant in myeloma. Early studies conducted in Europe and at the Fred Hutchinson Cancer Center in Seattle, WA, consistently demonstrated high treatment-related mortality (TRM) of approximately 45% in heavily patients receiving full myeloablative allogeneic transplant (full allo). Overall survival rates in these studies were generally less than 30% at five years. Full allo in myeloma patients was therefore largely abandoned worldwide in the early 1990s.

For the more than 3% of myeloma patients who have non-secretory or oligosecretory disease, and for the majority of patients with AL amyloidosis (AL), the traditional methods of measuring circulating monoclonal immunoglobulins (electrophoresis, immunoelectrophoresis, immunofixation electrophoresis, and nephelometric measurement of immunoglobulin heavy chains of serum) are not adequate.

The intent of this statement is to provide a biological classification of multiple myeloma and to establish the prognostic value of known genetic factors. Myeloma is divided at the highest genetic level into two subtypes: disease that is hyperdiploid (h-MM), and disease that is non-hyperdiploid (nh-MM). The non-hyperdiploid type is characterized by immunoglobulin heavy-chain (IgH) translocations and is generally associated with more aggressive disease and shorter survival.

The International Myeloma Working Group established the below criteria in order to: facilitate precise comparisons of efficacy between new treatment strategies in trials, incorporate the serum free light chain (FLC) assay to include assessment of patients with oligo-secretory and non-secretory disease, provide stricter definitions for CR (complete response), provide classifications that would improve detail and correct inconsistencies in prior response criteria.

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