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

“International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma,” published in The Lancet Oncology, November 2014. 


This International Myeloma Working Group consensus updates the disease defi nition of multiple myeloma to include
validated biomarkers in addition to existing requirements of attributable CRAB features (hypercalcaemia, renal
failure, anaemia, and bone lesions). These changes are based on the identifi cation of biomarkers associated with near
inevitable development of CRAB features in patients who would otherwise be regarded as having smouldering
multiple myeloma. A delay in application of the label of multiple myeloma and postponement of therapy could be
detrimental to these patients. In addition to this change, we clarify and update the underlying laboratory and
radiographic variables that fulfill the criteria for the presence of myeloma-defining CRAB features, and the histological
and monoclonal protein requirements for the disease diagnosis. Finally, we provide specifi c metrics that new
biomarkers should meet for inclusion in the disease defi nition. The International Myeloma Working Group
recommends the implementation of these criteria in routine practice and in future clinical trials, and recommends
that future studies analyse any differences in outcome that might occur as a result of the new disease definition.

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