International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma

This IMWG consensus “updates the disease definition of multiple myeloma to include validated biomarkers in addition to existing requirements of attributable CRAB features (hypercalcaemia, renal failure, anemia, and bone lesions).” Patients with smoldering myeloma inevitably develop CRAB features, and it has been noted that these patients have biomarkers associated with these CRAB features. If a smoldering myeloma patient is not labeled to have multiple myeloma in a timely manner, therapy may be postponed and this could have detrimental results.

Furthermore, the IMWG has provided an update on

  • “the underlying laboratory and radiographic variables that fulfil the criteria for the presence of myeloma-defining CRAB features, and
  • the histological and monoclonal protein requirements for the disease diagnosis.”

Finally, the IMWG provides specific metrics on new biomarkers that may indicate disease diagnosis.

The IMWG recommends this criteria be implemented in routine practice and future clinical trials. They also recommend that “future studies analyze any differences in outcome that might occur as a result of the new disease definition.”


S. Vincent Rajkumar, Meletios A Dimopoulos, Antonio Palumbo, Joan Blade, Giampaolo Merlini, Maria-Victoria Mateos, Shaji Kumar, Jens Hillengass, Efstathios Kastritis, Paul Richardson, Ola Landgren, Bruno Paiva, Angela Dispenzieri, Brendan Weiss, Xavier LeLeu, Sonja Zweegman, Sagar Lonial, Laura Rosinol, Elena Zamagni, Sundar Jagannath, Orhan Sezer, Sigurdur Y Kristinsson, Jo Caers, Saad Z Usmani, Juan Jose Lahuerta, Hans Erik Johnsen, Meral Beksac, Michele Cavo, Hartmut Goldschmidt, Evangelos Terpos, Robert A Kyle, Kenneth C Anderson, Brian G.M. Durie, Jesus F. San Miguel

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