The IMF was proud to sponsor the fourth meeting of the International Myeloma Working Group (IMWG) at the time of ASH 2001. There was participation from all of the major myeloma groups around the world. This project was initiated by the foundation at the IMF Scientific Advisors retreat in May 2000, in collaboration with Profs. Jesus San Miguel (Salamanca, Spain) and Philip Greipp (Mayo Clinic, USA). Since then, the group has met at ASH 2000 and at the 2001 Banff International Myeloma Workshop. Based on the results and further plans presented at ASH 200, major progress has been made.

Dr. Durie (Cedars-Sinai, USA) provided an overview of the initiative to be followed by Dr. Kyle (Mayo Clinic, USA) who summarized plans for the new classification and staging system. The proposal covered MGUS, ?smoldering myeloma? (name to be changed!), symptomatic myeloma, non-secretory myeloma, plasmacytomata and Waldenstrom?s. There was much discussion about criteria for active or symptomatic myeloma versus MGUS or inactive/asymptomatic disease. Remarkably, a clear consensus was reached ? the full details will now be brought together and written up by the working group for publication. Since all major myeloma groups have been involved, it is hoped that for the first time ever an accepted international classification system can be introduced. This is enormously important for the evaluation of all new treatments. This project will help not just investigators, but pharmaceutical companies with drugs under development and of course patients who need clear guidance for diagnosis and treatment decisions.

Dr. Greipp, who chaired the session, asked Dr. Joan Blade (Barcelona Hospital Clinic, Spain) to present details of accepted myeloma response criteria. A report was previously published by the working party of the International Bone Marrow Transplant Registry (IBMTR) in the British Journal of Haematology (102: 1115-1123, 1998). It was agreed to adopt most of these recommendations with minor revisions and publish the criteria along with the new classification system as soon as possible in 2002.

The final session dealt with the establishment of a new prognostic index using historical data from all of the collaborating myeloma centers. The data to be used for analysis was clarified and plans made to proceed with data gathering, collation and statistical analyses. This whole project is supported by an unrestricted grant from the IMF. The year 2002 should see major strides both in publishing results and in developing the new index. The working group will reconvene at the time of the Oxford Trialists meeting in Oxford, England in March 2002 and proceed from there. It was clear that all participants were extremely pleased with the progress and look forward to completing this important project, which serves as a benchmark for all future myeloma clinical trials.