International Myeloma Working Group diagnostic criteria for relapsed disease in multiple myeloma
| Nonaggressive relapse . | ||
|---|---|---|
| Biochemical relapse . | Symptomatic relapse . | Aggressive relapse . |
| Progression based on increase of M-protein | Slow inset of clinical symptoms and slowly increasing M-protein | Adverse cytogenetic abnormalities, eg, t(4;14), del(17p), ampl (1q21), hypodiploidy |
| No associated symptoms or MM-related organ dysfunction | Progressive disease with prominent symptoms and/or significant organ compromise | High β2M (>5.5 mg/L) or low albumin (<3.5 g/dL) |
| Presence of extramedullary disease | ||
| High LDH | ||
| Short duration of response or progression while on therapy | ||
| Aggressive clinical presentation including: | ||
| • Rapid onset of symptoms | ||
| • Extensive disease on laboratory, radiography, or pathology findings | ||
| • Disease-associated organ impairment | ||
| Circulating plasma cells | ||
| ISS stage II/III at relapse | ||
| Isotype transformation (light chain escape, hyposecretory disease) | ||
| Nonaggressive relapse . | ||
|---|---|---|
| Biochemical relapse . | Symptomatic relapse . | Aggressive relapse . |
| Progression based on increase of M-protein | Slow inset of clinical symptoms and slowly increasing M-protein | Adverse cytogenetic abnormalities, eg, t(4;14), del(17p), ampl (1q21), hypodiploidy |
| No associated symptoms or MM-related organ dysfunction | Progressive disease with prominent symptoms and/or significant organ compromise | High β2M (>5.5 mg/L) or low albumin (<3.5 g/dL) |
| Presence of extramedullary disease | ||
| High LDH | ||
| Short duration of response or progression while on therapy | ||
| Aggressive clinical presentation including: | ||
| • Rapid onset of symptoms | ||
| • Extensive disease on laboratory, radiography, or pathology findings | ||
| • Disease-associated organ impairment | ||
| Circulating plasma cells | ||
| ISS stage II/III at relapse | ||
| Isotype transformation (light chain escape, hyposecretory disease) | ||
LDH, lactate dehydrogenase.