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Multiple Myeloma Response Criteria

Classifies treatment response (CR, VGPR, PR, SD, PD) using IMWG uniform response criteria.

Multiple Myeloma Response Criteria
Baseline serum M-protein
g/dL
Current serum M-protein
g/dL
Baseline 24-hour urine M-protein
mg/24h
Current 24-hour urine M-protein
mg/24h
Bone marrow plasma cells
%
Serum immunofixation negative
Urine immunofixation negative
Soft-tissue plasmacytomas resolved (or absent at baseline)
New bone lesions, new/enlarging soft-tissue plasmacytomas, or new hypercalcemia
Complete the fields above to see the result.

When to use

  • Grading disease response during or after multiple myeloma treatment for clinical decision-making or trial reporting.

Formula

CR: negative serum/urine immunofixation, resolved plasmacytomas, BM plasma cells <5%. VGPR: ≥90% serum M-protein reduction and urine M-protein <100 mg/24h. PR: ≥50% serum M-protein reduction with ≥90% urine reduction or urine <200 mg/24h. PD: new lesions/hypercalcemia (or ≥25% rise from nadir).

Pearls and pitfalls

  • Stringent CR (sCR) additionally requires a normal serum free light chain ratio and absence of clonal cells by immunohistochemistry/flow cytometry.
  • For non-secretory myeloma, serum free light chain assays or PET/CT-based criteria are used instead of M-protein.

References

  1. Durie BGM, et al. Leukemia. 2006;20(9):1467-1473.
  2. Kumar S, et al. Lancet Oncol. 2016;17(8):e328-e346.