Cited by 350Multiple Myeloma Research and TreatmentsBone health and treatmentsChronic Lymphocytic Leukemia Research

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Updated Diagnostic Criteria and Staging System for Multiple Myeloma

Rajkumar, S. Vincent·2016·American Society of Clinical Oncology Educational Book

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Abstract

There has been remarkable progress made in the diagnosis and treatment of multiple myeloma (MM). The median survival of the disease has doubled as a result of several new active drugs. These advances have necessitated a revision of the disease definition and staging of MM. Until recently, MM was defined by the presence of end-organ damage, specifically hypercalcemia, renal failure, anemia, and bone lesions (CRAB features) that can be attributed to the clonal process. In 2014, the International Myeloma Working Group (IMWG) updated the diagnostic criteria for MM to add three specific biomarkers that can be used to diagnose the disease in patients who did not have CRAB features: clonal bone marrow plasma cells greater than or equal to 60%, serum free light chain (FLC) ratio greater than or equal to 100 provided involved FLC level is 100 mg/L or higher, or more than one focal lesion on MRI. In addition, the definition was revised to allow CT and PET-CT to diagnose MM bone disease. These changes enable early diagnosis and allow the initiation of effective therapy to prevent the development of end-organ damage for patients who are at the highest risk. A new staging system has been developed that incorporates high-risk cytogenetic abnormalities in addition to standard laboratory markers of prognosis.

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Authors: Rajkumar, S. V.
Affiliations: Mayo Clinic (US)
Corresponding author: Rajkumar, S. Vincent
ORCID: Rajkumar, S. Vincent
Venue: American Society of Clinical Oncology Educational Book
Publisher: American Society of Clinical Oncology (ASCO)
Published: 2016-05
Volume: 36
Issue: 36
Pages: e418-e423
ISSN: 1548-8748 (ISSN-L)
1548-8756
DOI: 10.1200/edbk_159009
OpenAlex: W4245689579
Cited by: 350
References: 33
Citations by year: 2026: 29 · 2025: 37 · 2024: 46 · 2023: 50 · 2022: 52 · 2021: 50 · 2020: 32 · 2019: 23 · 2018: 17 · 2017: 14
FWCI: 2.56
Type: journal article
Language: en
Open access: closed
Locations: American Society of Clinical Oncology Educational Book (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Hematology › Multiple Myeloma Research and Treatments
Health Sciences › Medicine › Oncology › Bone health and treatments
Health Sciences › Medicine › Hematology › Chronic Lymphocytic Leukemia Research
Keywords: multiple myeloma, diagnostic criteria, disease staging, serum free light chain ratio, bone lesions, high-risk cytogenetics, prognosis
MeSH terms: Positron Emission Tomography Computed Tomography, Bone Marrow Cells, Humans, Magnetic Resonance Imaging, Multiple Myeloma, Neoplasm Staging

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Updated Diagnostic Criteria and Staging System for Multiple Myeloma

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